rehabbing from presumed disc herniation

Pain & Rehab Forum [Moderated]
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2 weeks ago I am pretty sure I herniated my L4-5 disc. This happened during deadlift warmups. Basically I had sudden severe pain in my back that then localized in my right leg. It was pretty bad for a couple hours, but then was much less painful. It’s getting better almost daily, but my leg hurts, goes numb, or somehow both at once if I stand too long or walk too far (the time and distance to cause symptoms has been steadily increasing, which is encouraging). The sensations were complicated, but corresponded roughly to an L4 distribution.

Anyway, after a couple days I was lifting again but basically upper body only: bench, chins, etc. I have now resumed squatting, and am working the weights up very slowly (yesterday I did 115lbs for a couple sets of 5, for comparison my previous e1RM was about 350).

My plan is to gradually titrate up the weight on squats, and then start doing some very light rack pulls and titrate those slowly too. Once I can do some decent weight at rack pulls, I will gradually increase the ROM back to lifting from the floor.

I am torn between a desire to get back to where I was without too much detraining, and on the other hand a near phobia that I will have that severe pain again. So I have both the urge to rush things, and the urge to never lift heavy again. Given that neither of these would be good, do you have any pointers for how I can structure and progress things and avoid the extremes? Or any suggested exercises for this particular situation?

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This is a situation that we deal with very commonly, and the general concepts / approach are discussed in the free content we’ve put out on pain if you need a place to start. There are no specific exercises we’d insist upon including or avoiding in general, either - a lot of this comes down to individual tolerance and their goals.

With that said, I would strongly encourage a consultation with our team to help flesh out more of the individualized side of things, specifics of programming structure, etc.

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Thanks. I’ll consider a consult as I see how things go. I’ve found my way through most of the pain stuff here, which has guided my initial plan. Your work here is very helpful.