Hi Dr’s.
I am a 38 year old male. I have a herniated disc with some radiculapothy that occurred 4 years ago at L5 S1. After a year of pt and several epidural injections failed to relieve issue , I began strength training. For the past 2 years using proper form, techniques and methods (ss,bbm templates and form, diets etc), this has allowed me to manage any remaining pain and minimize all symptoms.(and train untamed)Nerve pain had diminished to 0 unless I used poor form or overextended myself. Recently I did managed to tweak back slightly playing golf and had some minor nerve pain no different than at other times and continued to train through it… HOWEVER, while deadlifting, I felt a pop in hamstring followed by nerve twinge down left leg to toes, extreme tightens in glutes, hamstrings and a little tightness in back. This is different experience than in the past with this issue. This occurred one week ago. I attempted squatting light a couple days after with severe pain in the first rep and lesser pain on subsequent reps. This happened for each set. A friend and pt believes the herniated disc has shifted further into the spinal column(?) causing new and different pain. And believes I should wait until symptoms dissipate before beginning squats or Deadlift again (A MONTH OR SO). Currently nerve pain is pretty consitant, hurts standing, walking, moving from sitting to standing and vice versa, cannot walk with a normal gate without pain. Also extension of lower back causes severe nerve twinge. Tightness in glutes an low back has diminished and really have little pain in back.
So…my question is, do I train through it, should I back off lower body lifts until nerve flare up subsides. Is there something else I should be doing?
thank you for takiing the time to adress my concerns.
I’m sorry to hear about your exacerbation of symptoms. I highly doubt that it is your “disc shifting further into your spinal column.” If this happened 4 years ago, we have pretty good evidence now that discs do heal within about 2 years in the longest scenarios. Spontaneous regression of sequestrated lumbar disc herniations: Literature review - PubMed
I would advocate “training” through it an emphasize the quotation marks in this instance. Trying to shoot for an RPE 8 in the traditional sense is likely not in your best interest with an acute flare up of symptoms, but there is no reason you still cannot work on the movements to tolerance. Often it is about slowly increasing tolerance back to prior levels whether it be decreasing the weight, working on rack pulls, or squatting to a tolerable depth, increasing depth over time. The same paper tagged above states symptomatic resolution typically occurs within 2-3 months but there is no reason you cannot train, within reason, during that time. Many of us have been there, myself included, and this period comes down to finding what your tolerance is, and increasing it over time. You can think of RPE as not just the physical struggle of muscles burning, but the multifactorial nature of realizing you are healing and what is “difficult” now, is different than before, but it is still about slowly increasing tolerance to constantly redefine difficult.
Thank you for your input, greatly appreciated, began training squats on Monday (10 days out)working with relatively light weight, the unracking and walk out along with the first rep are still really painful,but remaining reps feel okish. I know pain is not a good indicator of injury but is it ok to traIn through,given the pain. Deadlifts at a reduced weight cause little to no pain. I’m willing to train through, just doesn’t seem productive,but then again I really don’t trust my feelings. Thanks again .for your input