So frustrated regarding training and my awful back

[WNC]

Long story as short as possible…I’ve struggled with back issues for 2 decades. I’m a 42 yo male. I have successfully ran the traditional NLP twice in the last 6 years. I had a discectomy/laminectomy in 2018. After recovery I found you guys on another site and ran the NLP successfully. Last April I had a bad flare up that prompted another trip to the ortho for an MRI. I will include the findings at the end of this post. My biggest question is will I ever be able to get back under the bar for squats and deadlifts? My ortho has advised strongly against it but he has no back ground in strength training. I have been left with permanent nerve damage in both calves that can affect my balance. I have been experimenting with very light weights and as long as I stay mid foot I can perform the lifts with no pain. I’m not asking for full on diagnosis, just informed opinions on if barbell lifting is still something I can pursue. My nutrition is finally on point and I’m slowly working my body weight down from 300lbs to somewhere around 230. Of I can’t do the barbell lifts any longer then so be it but I wanted to at least ask. I asked this question in another forum and got all types of condescending non answers. I’ll let you guess which one. Here’s myMRI Findings:

1. L4-L5 right laminotomy and microdiscectomy. A 1 cm right subarticular disc protrusion covered by nodular scarring resulting in moderate canal stenosis, encroachment of the right lateral recess and impingement of the descending right

L5 nerve root.

2. L5-S1 left laminotomy and microdiscectomy. A 2 cm broad central and left subarticular disc protrusion resulting in moderate-severe canal stenosis and impingement of the descending S1 nerve roots more conspicuous in the left.

3. L1-L2 asymmetric disc bulge producing mild canal stenosis, narrowing of the left lateral recess with contact and partial effacement of the descending left

L2 nerve root.

4. L2-L3 asymmetric disc bulge with superimposed lett lateral recess with contact and partial effacement of the descending left

L2 nerve root.

4. L2-L3 asymmetric disc bulge with superimposed small central disc protrusion

producing mild canal and mild left foraminal stenosis.

Partial effacement and contact of the exiting left L2 nerve root.

I also currently have no associated pain, foot drop, etc thank you for your time…

[Jordan_Feigenbaum]

WNC,

Howdy! It’s good to have you here and we appreciate the detailed background info. We can certainly guess which other forum you visited. Hopefully we can help you a little bit.

An immediate caveat however, I cannot give you an interpretation of your MRI or provide medical advice via a forum. We do offer consultations in situations where people want to talk about their specific scenario, which may be a good option for you pending your preferences. That said, the MRI doesn’t affect what I’d personally do if it were me. It’s more about what the person can do, their symptoms, and so on vs what the paper says.

Regarding whether someone like this can squat or deadlift again, the answer is obviously yes. You’re already doing it. I’ll withhold judgement about your orthopedist since there are details of your case that I’m missing, but it may be worthwhile asking them why they are advising against it, i.e.g what specifically are they worried about, for how long will that worry persist, and how does that square with your preferred activities, goals of treatment, and so on.

Because free weights place a unique demand on balance, my biggest concern with squats (less so with deadlifts) would be related to this. If I could perform squats in a way that was mostly repeatable rep-to-rep, efficient (balance maintained, decent bar path), and met the points of performance (below parallel), then I’d be satisfied with technique. The next question becomes, is it “trainable”, i.e. can you load it, is it painful to perform, and so on.

As you know, exercise works better for health when it actually improves your fitness. With that in mind, if someone weren’t able to squat (or deadlift) in a way that was very trainable - which may be temporary - I would relegate the squat and deadlift to accessory-type movements they could do for practice, while selecting other exercises to load in a way that actually made them stronger/preserved strength. This may be the case with you right now based on your description.

Without knowing more, I would be thinking about a leg press as your “main” squat pattern, while doing some sort of free weight squat pattern as an accessory lift for practice. Perhaps a tempo box squat or something, starting very light to make sure you can tolerate it, and then gradually working up over time.

This is something our pain and rehab team does regularly as well, which may be another option for you, if interested. They can be contacted here.

Lastly, and perhaps a tangent to the information you’re looking for, I have serious reservations about running the Novice Linear Progression (NLP) in anyone, but especially in a situation like this. My main criticisms are: 1) it is hyperspecialized (limited exercise variability, limited rep range variation), 2) no autoregulation, 3) a progression model that is incompatible with human physiology that leads to irrational behavior (e.g. “adding 5lbs” before you’ve actually gotten stronger) 4) no conditioning, and so on. If people get into lifting weights via this program, that’s great. We love to see it. However, there are real deficiencies in the program and in the modern day, there are better options.

[WNC]

Jordan, thanks so much for the well thought out reply as it does answer my question fairly well. As of now I’ve been trying to use the belt squat and leg press as my main driver for strength. My orthos perspective, I believe, has s the stenosis doesn’t give my spine the wiggle room to be less than perfect. My line of think at this point is to continue what I’m doing and start slowly working in low bar squat and deadlift while I finish up my fat loss. At that point I’m going to purchase one of the programs here and run in when my caloric intake gets back up to maintenance or a slight surplus. Thanks again for taking the time to answer and I look forward to starting fresh here.