Sorry for the double post, I forgot to include my MRI results in the last one
Hello,
I hope the Barbell Medicine team is doing well.
I’m a 27-year-old male with type 1 diabetes, and I’ve been lifting consistently for over 5 years. About a year ago, I believe I slept in a bad position and woke up with what felt like a neck strain. I expected it to resolve quickly, but after 2–3 weeks it was still bothering me.
I didn’t want to take too much time away from the gym, so I returned to lifting. I started noticing tightness in my left upper trap during exercises where I normally wouldn’t feel that area working much, such as dumbbell shoulder press, pec deck flys, and overhead tricep extensions.
I tried to push through it, but during a dumbbell shoulder press one day, I felt a sudden “pop” in that area and immediately knew something was wrong. I dropped the weights and went home. Over the next week, the pain became much worse, to the point where I was walking around with my left shoulder shrugged up due to pain and tightness.
It eventually got bad enough that I went to the ER. I asked for an MRI, but they only performed an X-ray and prescribed steroids. The steroids helped significantly and brought the pain down. After that, I followed up with my doctor, who suspected I may have torn my trap, but he didn’t want me to get an MRI at the time because I didn’t have insurance and the cost would be high.
After another 3–4 weeks, I tried lifting again and re-injured it during an overhead tricep extension. The pain returned heavily. I couldn’t sit upright comfortably and had to work from home in a very slouched position. Even after 10 minutes at my desk, I’d need to lie down with my head supported against the headboard just to tolerate the discomfort.
Over time, the pain slowly improved, but it never fully went away. I also tried physical therapy, but honestly, it didn’t seem very helpful, and some of the exercises felt unrelated to what I was dealing with.
I eventually got an MRI, which showed two herniated cervical discs. During my consultation, the neurosurgeon recommended trying physical therapy again for another 3–4 weeks, and if that doesn’t help, moving forward with ACDF surgery.
My main goal is to get back to training consistently and return to jiu-jitsu. I had a few questions regarding my situation:
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How exactly would physical therapy help in this case? My understanding is that once a disc is herniated, it doesn’t simply “slide back in,” so I’m struggling to understand how PT would resolve the issue.
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Since I do both lifting and jiu-jitsu, I worry that if I avoid surgery, the risk of reinjury will remain high. Is that a valid concern?
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The surgeon mentioned that he believes the herniated discs may have calcified and that the discs have flattened, which is why my recovery seems to have plateaued. He also said I’ll likely need ACDF eventually regardless. Does ACDF significantly limit neck range of motion, especially for things like turning my head while driving or training? I want to still maintain ROM if at all possible
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Most of the time I feel okay now, but smaller movements still cause discomfort—things like looking down to buckle my belt or checking my blind spot while driving. I know I can’t do overhead movements, my brain is telling me I’ll get reinjured when I try. Is it reasonable to continue lifting for now if I avoid overhead movements?
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Do you have any general advice regarding managing this condition while trying to stay active and eventually return to lifting and jiu-jitsu?
I’d really appreciate any insight. Thank you for your time.
Impression
1. Moderate to large herniated disc at C5-C6 on the LEFT side extending out slightly laterally. 2. Small herniated disc slightly to LEFT of midline at C6-C7. 3. No axial images were obtained through the C7-T1 level. I do not see any disc herniation or canal stenosis in the sagittal plane.
Narrative
MR cervical spine without contrast History: Neck pain with radiation to the LEFT trapezius for one year. T1-T2 and STIR sagittal as well as T2-weighted axial imaging of the cervical spine was obtained. Correlation is made with plain films of the cervical spine dated 7/21/2025. There are 7 cervical segments. There is loss of the normal lordotic curve. The cervical vertebrae maintain their stature and have a normal T1 and T2 appearance. There is mild interspace narrowing at C5-C6 and minimal narrowing at C6-C7. The cervical cord has a normal T1 and T2 appearance. Foramen magnum appears unremarkable. At the C2-C3 through C4-C5 levels there is no evidence for a disc herniation or canal stenosis. I do not see any foraminal narrowing. At the C5-C6 level there is a moderate to large disc herniation centrally and on the LEFT side severely narrowing the LEFT lateral recess and indenting the LEFT side of the thecal sac and displacing the LEFT side of the cord posteriorly. It extends out somewhat laterally. I do not see any foraminal narrowing on the RIGHT side. At the C6-C7 level there is a small disc herniation slightly to LEFT of midline mildly indenting the thecal sac. No canal stenosis present. I do not see any foraminal narrowing. At the C7-T1 level the axial images did not reach this level. I do not see any disc herniation or canal stenosis in the sagittal plane and the intervertebral foramen appear widely patent on the sagittal images.