Back pain, QL?

Medical Q&A [Moderated]
1

Dear Barbell Medicine crew,

I have question regarding lower back pain when doing deadlifts and would really appreciate your answer. Description is a bit long because it’s not so simple, since I also had operation on my kidney.
I am a 35 year old female who has been training seriously with weights for about 8 months. I started with SSLP, did half of The Bridge program and then went on a powerlifting program in January this year. In January I also switched from conventional deadlifts to sumo deadlifts. I had my first meet in March.

In the last weeks of preparing for the meet I started to feel pain on the right side of my low back. The pain was not that low, more:low to mid back, but under ribcage level. It was not severe, nothing poped and pain gradually increased mostly after heavy sumo deadlifts (I didn’t do conventional deadlifts at that time only sumo with mixed grip, right hand in pronation). Later also when doing squats, but I never knew if it was only the deadlifts that caused the pain, or both deadlifts and squats. The pain was not big, at first I felt it when lying on the bench, after two days when taking a big breath, or doing side bends. Every time I had 2-3 days off (I train 4 times a week, weekend and sometimes Friday I rest), the pain would minimalize or go away. As I started to deadlift, the pain returned. On the last two weeks before the meet I started to feel not really pain, but uncomfortable feeling lower on the right side of the back, spreading in my right hip, down my right leg, knee, and right side of calves (sciatica).

I would like to stress out that I had 2 operations on my right kidney (diagnosis: kidney hydronephrosis – due to wrongly curved ureter – something I was born with). First operation was 18 years ago (I was 16 at the time) and second due to kidney stones 5 years ago. I haven’t got any problems with kidney since then (dynamic kidney scintigraphy showed that my left healthy kidney works 52% and my right 48%: both together 100%, which was encouraging results, but the right kidney is slower and weaker and “bed texture” – that was said after my second operation).

I mentioned all this, because at first the pain was similar to kidney pain so I freaked out. After google all about it, I’ve read it could possibly be the quadratus lumborum muscle. Since it attaches on the pelvis it can, beside low and middle back pain, cause sciatica symptoms. So before and after the meet every time I did trigger point massage just above pelvis line I felt better. After the meet I had 2 weeks off (doing really light conventional deadlift), trigger point massage, the pain and sciatica symptoms gradually disappeared.

But now as I started to train with heavier weights again, the pain and sciatica symptoms are coming back (mild). I have always watched my form, so I doubt it has to do with disc hernia. At least I hope so.

So my questions are:

  • I don’t round my back when doing deadlifts (only 1 time when I was doing 1MR), but could it still be disc hernia? I do have 18 months old toddler who I lift with round back many times on daily basis L

- Could it be QL muscle and if that’s the case, what could I be doing wrong when sumo deadlifting to affect QL to hurt and how can I fix it? How can anyone tell if it’s really QL muscle, or maybe erector spinea or maybe any other muscle?

- Could the pain be associated with belt: e.a: belt to tight squeezing right kidney – is this even possible? Belt to tight for muscles when doing Valsalva? Wearing the belt to high or too low to cause pain. If yes, why only on the right side?

  • Could 2 operations weaken the right side of trunk muscles and that is the reason for QL or any other muscle pain?
    In what degree can body asymmetries (my right shoulder is lower than the left on) cause pain when lifting?

Other info: I’m 160 cm tall, 56 kg, feeling healthy, nutrition and sleep are not perfect considering I have a toddler (sleep), but they are ok.

I hope my questions don’t cause you a headache.

Again, I would really appreciate your answer, because I really want to continue training and attend next meet (in the fall this year).
Best regards!

2

Hi Liftup,

  1. A disk hernation is always possible, even in people without symptoms. And for people with herniated disks and back pain without other concerning features, we still advise them to train. So I would not panic over this possibility.

  2. No one can really tell to what extent a single specific structure is causing symptoms, because pain is more complex than this. Have you by chance listened to our two podcasts on pain and injury?

  3. No - belts do not “squeeze the kidney” and cause pain.

  4. This is also unlikely to be the case, since you have presumably lived the past 15 years since your surgery without this pain. Additionally, weakness does not cause pain.

  5. Every person is asymmetrical and, to an extent, exhibits some asymmetries when they lift. This is normal.

I would recommend you 1) listen to our two podcasts, 2) get a form check, and 3) see whether your programming is appropriate.

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