Spondylolysis

Medical Q&A [Moderated]
1

Hello Doctors,

About 10 years ago (at age 19) I fell and had a spondylolysis on both L4 and L5. There was poor follow up, so I don’t know if they are healed.

I can still feel some clicking sensations while hyperextending. I had two additional MRI’s when I was in pain again years later, but they didn’t see anything. Also no old trauma.

As an occupational therapist working with the elderly I’m not new to hearing someone having pain without it being visible on MRI.

The pain in my lower back comes and goes, which I’m used to.

But the last period (1 year) it hurst when taking the bar out of the rack and putting it back followed by the decompression of the area. Squatting & deadlifting itself doesn’t hurt. But building up and releasing the compression does (sometimes a whole lot). I used to push trough the pain, but I only gets worse.

I did a period of lighter volume work, so my back stopped hurting. But working up to a meet, it got worse again. I try to move it around as much as possible, do air squats and such. Which helps.

I can take pain killers and inflammatory medicine all I want. It does nothing. Light movement and training just below the pain barrier works best.

BUT, do you have an other advice that could help me? Squatting and deadlifting 440lbs @175 is kinda ok, but I’d like to think I have more in me.

Thanks for all the content. Really looking forward to the next installment of the programming podcast.

Kind regards,

Steven

2

Hey Steven,

That description of pain upon unracking and re-racking is pretty common. I doubt it has anything to do with your old injury, to be honest.

I agree with your approach of modulating your intensity (i.e., periods of lighter volume work, or even when you start to ramp things up for a meet, not everything needs to be circa-max grinders).

Additionally, I’d make sure you’re wearing a belt, I’d check your technique (for both the unrack, walkout, squat, and re-rack - sometimes people don’t get their hips all the way under the bar when unracking, for example), and finally consider incorporating some alternative squat variations (e.g., high bar, SSB, front squat) to see if you tolerate them better.