I made a post in the FB group and Leah said this might be a better spot to get some help without all the yahoos chiming in with their crazy theories.
I’ve had a recurring back injury for the past 3 years or so on my right side in the L4-L5 area. I’ve injured it squatting and deadlifting. Each time there is a noticeable pop in the aforementioned area. It puts me out for a few days and I ease back into training. The past two times it’s taken 4-6 months to feel normal and pain free again. Had an X-ray when I re-injured it last year which came up negative for any abnormalities other than a slightly compressed disc and I just continued to desensitize to training and was able to work back up to a 425lb PR squat around the first of the year 2019. The most recent re-injury was about 20 weeks ago when I felt the tell tale pop during a warm up squat set with 225lbs. I watched Alan’s vid when it happened and kept moving as best I could and in a week I was back up to my working sets as usual. The pain actually goes away when I’m training and the injury itself doesn’t inhibit me other than the slight fear sometimes that I will re-injure myself during heavier sets. The pain lingers throughout the day though and even though I know it’s likely to get better over time and there’s likely not anything structurally wrong with my back the pain is getting worse as I go on.
I think it may be do to the nature of my work and the fact that my overall stress has increased in the past few months. At my job I am driving all across the city during the day. Sometimes I spend ~6 hours a day driving. I feel pain in my low back about half the time when driving and just about every time I get out of my van I feel pain and tightness anywhere from a 3-8 occasionally accompanied by some tingling down my right leg for about 30-45 secs after I get out. As I walk around it gets better. This also happens after I stand up from a seated position and when I get up from bed after sleeping.
I also have had some increased stress over the past 12 weeks. My wife gave birth to twins on June 16 and Twin Girl B was PAU when she was born with an APGAR of 0. She was able to be resuscitated after much work by myself, Phoenix FD and Banner University’s NICU team and is doing very well considering her previous condition and initial prognosis. I’m not sure how well I have coped with this stress. My wife and I also have two other children under 4 and my boy is in the peak of his “terrible twos”. I’m often finding myself unable to cope with his tantrums and whining and have had a few anxiety attacks over the past 8 weeks. As I hope you can imagine with everything that has happened I am at a baseline level of stress that is probably higher than it has ever been in my life.
The reason I’m concerned is that my back pain is getting worse over the past couple weeks, seemingly in line with increased stress. Waking from sleep, during sitting and lying, and during the work day it is more intense and frequent, and even though it doesn’t hinder my training it seems like the only time I’m not in pain is when I’m training. I’m hoping you guys can give me some guidance for how I could be more effective in treating this as I’m starting to become emotionally and mentally drained by being in pain constantly.
I don’t have much money to allocate to treatment, but with the twins birth I am approved for State Poor People Insurance. I’m hoping ya’ll could point me to a trusted provider that accepts state healthcare in Phoenix if you think it would be necessary. Thanks for taking the time to read this.
Hey Isaiah - I’m really sorry to hear about the recent situation your family is involved in. Having recently become a dad myself, I can imagine the difficulties this situation has posed for you. The good news, sounds like the situation has improved. However, it also sounds like you have a lot going on in life currently and maybe are not managing as well as you previously have, which is understandable. I think it would be helpful to consult with one of us in the rehab department to talk through some of this, get some copping mechanisms in place, and create a map to help get you back to training (which I imagine is a stress-relief). If you need to go through insurance, I’m not familiar with anyone in Phoenix but perhaps the other team members may be. @Derek_Miles@Austin_Baraki@MikeAmato
Thanks for the response Dr Mike. I’d love to consult with one of you guys unfortunately I just can’t afford the cost out of pocket right now. I’ve listened to your LBP podcast and found it helpful, but just haven’t been able to see much change in pain levels lately.
Hey Isaiah,
I’ll piggyback on what Mike said and try and offer some simple advice. To say the stress you have went through recently is a lot is an understatement if there ever was one. I’m happy to hear your family seems to be doing much better.
In regards to what you are describing it sounds like an injury that would typically get classified as a strain.What you have described is how those often behave where things get back to prior levels then there is an expected “pop” and setback. When this happens, the steps you have taken will get you about 90% of the way there. Typically though, there is some focal weakness after a strain that benefits from some direct training. Like we talk about with Nordic Hamstring Curls or the Copenhagen Adductor Protocol, after instances like this doing some isolated back extensions could be beneficial. WIth hamstrings and adductors we typically advocate for doing them single leg so you can see a difference side to side in strength but that isn’t really possible with lumbar muscles. Here a simple program working on slow contractions on a Roman Chair, or even single leg RDLs can often be enough to target the area.
That being said, right now I think the biggest thing for you is just trying to be consistent in training. While I want you to continue to set PRs, it certainly sounds like you have a lot taking attention away from the gym (as it absolutely should right now). I would highly recommend taking a block to just work on the basics and think about building capacity in your lower back.
Thanks Dr D. I have access to one of those 45 degree back extension stations or a Rogue Reverse Hyper/GHD. Would either of those work in place of a Roman Chair? I know I could use the RH single leg.