About 3 weeks ago I experienced some lower back pain after overhead press. The pain progressed to my right glute and down the lateral side of my leg and calf - it was very painful, burning sensation what I would best describe as nerve pain, that lasted 1-2 weeks. It reduced my range of motion to touch my toes, constant pain worst pain when standing with some relief when sitting. I tried stretching and rolling my glutes; rolling really hurt but for whatever reason it seemed to help the pain and range of motion significantly (almost back to normal) but, this has scared me away from the OH press, at least for a while.
I’m left with some weakness in plantar flexion of my right foot (i.e. standing calf raise), some minor pain in my back/butt/leg, and some slight pins and needles in my right foot when going from a sitting to standing position. The flexion weakness is not constant, it improves after some rest, but gets fatigued quickly (like when I go for a run) - after about 12-24 hours the strength comes back when compared to left calf but I can only run about a mile or do 5-10 calf raises before noticing a clear difference again. I don’t seem to have issues with internal/external rotation of my leg or dorsiflexion of my foot (lifting toes).
My questions are:
Is this type of progression from pain to weakness “normal” and something that I can take a wait and see approach on? It seems I have some S1 nerve compression or inflammation that caused the issue and perhaps gently stretching and easing into strengthening is appropriate.
Or if more complex, what is my best next step? Consult with you, GP, Chiropractor, PT…?
Hi, thanks for the post and questions, hopefully we can help guide you!
1. Is this type of progression from pain to weakness “normal” and something that I can take a wait and see approach on? It seems I have some S1 nerve compression or inflammation that caused the issue and perhaps gently stretching and easing into strengthening is appropriate.
It’s very probable that you have some radiculopathy symptoms, and S1 seems very possible given your symptoms, and having some mix of sensory (pain, numbness/tingling) and motor (weakness) can be common with this presentation. This doesn’t make the prognosis any worse or better, but it does seem that your symptoms and function are slowly improving, which is definitely a good prognostic sign. What I would focus on is slowly progressing your strength, both in your calf and globally (squat, pressing, deadlifting). You may just need to scale back more than what you’re used to, and progress from there. You can easily start pressing again either with lighter barbell weights or dumbbells. Tracking loads, effort (RPE) and symptoms will help guide your progress. What did your training and activity look like prior to the injury?
2. Or if more complex, what is my best next step? Consult with you, GP, Chiropractor, PT…?
It’s less of a question of complexity but more of a question if you’re having issues self-managing and return to prior level of function. Your presentation can change significantly over the next few weeks, in a good way, so you can attempt to self-manage through graded return to activity, and if you feel like you’re not getting where you want to go, consulting with us is definitely an option. Depending on where you live, we may also be able to guide you to see a trusted clinician in your area.
Let us know if you have other questions or updates.