Lower back radiculopathy and returning to heavier lifting

Pain & Rehab Forum [Moderated]
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Hi guys!

For some background and context, I am physical therapist, however, I am also human and could use some guidance and “talking down” so to speak.

Last week, I was performing 1 inch sumo block pulls. At the end of my lower body session, I had significant back tightness. It felt more severe of tweak than I was used to, however, I have had similar instances before. I took a few days off from lifting, however, had to sit a lot over the weekend, as I was taking a continuing education course. On Sunday, I trialed re-introducing lower body, pushing where I could, and easing where I had to. I felt pretty good, however, when I tried to re-introduce high bar squatting, I felt numbness and tingling down my left lower extremity, all the way into my foot. Since then, I have taken a complete break from training, and am focusing on rehabbing the injury.

I am fortunate to work with great clinicians who are helping me manage my condition. However, they are not very well versed in barbell lifting. Based on what I do, I find that I am catastrophizing this injury. I keep perseverating on noting being able to squat or deadlift again. I was finding a ton of joy from lifting heavier, and I am worried that I will never get back to my previous levels. My symptoms are progressively getting better, and have decr numbness and tingling in my left leg, however, it is still present. I am nervous to get back into the gym and lift for the time being. My plan was to be pain free over the course of a week and then re-introduce the gym. Is this a good plan? Will I be able to return to the big 3? Can you give me any tips to help contextualize my issue so that I am not catastrophizing? I provide this council to so many patients, but I am a terrible self clinician. Thanks for reading and any guidance you can provide.

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Hi there, I’m sorry to hear about this issue. I know it’s easy for our thoughts and fears to spin out of control a bit during the early phases; however, you are already telling us some things that indicate a favorable prognosis.

The first is that your symptoms are seemingly limited to a sensory syndrome, mostly provoked by certain activities and positions, but are not including motor weakness. Most importantly, they are also already improving even within the first week.

We have routinely worked with lots of folks who, over time, are able to work back towards their preferred activities, including heavy barbell training, setting PRs, and competing at a high level. Charlie Dickson is one of our physical therapists and performance coaches. He suffered a very debilitating bout of sciatica many years ago and has since returned to competing at a very high level on the powerlifting platform, and is deadlifting back over 700 lbs.

So it is very possible with the right management and guidance. If you feel you need additional help, he (or any of our rehab coaches, who have also had similar experiences of their own) would be a phenomenal choice of coach to work with.

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Thank you Dr. Baraki. I appreciate the feedback. I will consider consultation with Charlie if I need further help with everything. It would be beneficial to hear from someone who went through the same issue and came back stronger.

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