Lower Back Pain and Training

Medical Q&A [Moderated]
1

Hello, everyone, I’m new here, been following you guys for some time, I truly appreciate all the work and great content you put out.

I realize this question (or something similar) must have been posted many times already, but yesterday I was watching a live video in Dr. Feigenbaum’s Instagram and he answered a question of mine, which I greatly appreciated, but it did leave me with a doubt in my mind, so I felt this might be an appropriate place to ask it.

I’ll cut the story short so as not to bore you all, been suffering from chronic back pain for 3.5 years, l5-s1 hernia detected, did all sorts of treatments and been to many doctors, most said the hernia was the cause and only one said the hernia might not be the cause.

I had been lifting 2 years prior to my injury, felt a sharp pain while doing a standing overhead press and that’s when the pain started, I should note I most likely had terrible form and had been obese prior to starting lifting.

Yesterday, Dr. Feigenbaum said he wasn’t sure my pain came from the hernia (something like only 5% of back pain is caused by hernia, if I remember correctly), and that unless it had been an accute episode he thought it most likely wasn’t caused by the hernia (forgive me if I’m remember incorrectly, getting this from memory).

I have recently decided to go back to lifting, mostly encouraged by many of your posts/articles/videos with regards to pain management and how to “cure” it, I have been doing romanian deadlifts for a few weeks now, trying to mimic Alan Thrall’s form (watched his video many many times), so far it has been ok, pain hasn’t gotten any worse in the big picture. My plan is to start actually deadlifting soon.

My question is this: If, for some reason, I’m in the 5% that have lower back pain caused by hernia, will following your strength programs (deadlift, OHP, bench press, low bar squat etc) cause my condition to worsen? Or is it something I shouldn’t worry about so much and just follow the program? I am 29 years old now, and 20kg overweight at the moment.

Sorry for the kinda long post, I tried to keep it short, and sorry for any spelling mistakes (English is not my mother tongue).

Thanks!!

2

It is likely that you will experience fluctuations in symptoms over time. However, we would suggest not trying to dissect out a specific individual “cause” for the pain, as this is not possible in the overwhelming majority of cases. Furthermore, even if we could, the treatment recommendation would most likely involve continued exercise and physical activity – in other words, we would still not recommend you avoid resistance training.

So, we recommend you train, and continue to educate yourself about this process so that if/when you experience a setback, you know what to do.

If you need additional individualized assistance, our rehab clinicians would be happy to consult with you.

3

Thank you kindly for your swift reply! I feel somewhat reassured now that you said you would most likely recommend continued exercise, whether the pain was being caused by the hernia or not. I will continue to educate myself on the matter and try to deal with the pain.

For someone in my situation, would you recommend the beginner template or the lower back rehab template?

Thanks again!

4

It’s hard to say whether you’d do significantly better with one over the other without knowing a whole lot more information about your symptoms and training history. However, if you are still dealing with significant symptoms I’d lean towards the back pain template.