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2007/07/13, 05:23 PM
posting more often in this forum. Since my future occupation revolves around keeping people healthy, I need the practice. However, I typically avoid it because doing this kind of stuff over the internet is shady. The first step in a therapuetic examination is postural evaluation, I can't do this over the internet.
That said, I STILL recommend seeing a PT or Doctor for anything you need to post here. However, assuming no liability, I will try to help some of those who post.
Here's what I'd like in return:
1. Where does it hurt? Give as best a description as you can.
2. How does it hurt? What kind of pain is it? Dull, throbbing, stinging, sharp, stabbing, acheing, etc?
3. When did it start hurting? What were you doing at the time?
4. When does it hurt? While lifting, standing, sitting, stretching, etc.
5. Constant, intermittent, when doing certain movements?
6. Does the pain radiate to other parts of your body?
7. Range of motion? What movements can or can't you do?
8. What makes it worse, better?
9. What is your main concern regarding the pain and its consequences?
10. Any prior injuries?
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Mortal by birth.
Strongman by the grace of god.
Blood Guts Sweat Chalk
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2007/07/14, 06:50 PM
I will give it a shot. I went to my primary Dr last week and I am scheduled to see an orthopedic in a few weeks for my lover back pain.
1) Lower back - from center of back to the obliques.
2) Typically it is a tightening/stiffening of the muscles in that area, it spreads across the entire lower back, starts on the right side and moves left, more of an acheing. Hard to stand upstraight.
3) Have had this problem for years. Do not recall a specific injury.
4)It hurts when leaning over for extended periods of time. For example, leaning over to brush the dog, change a car battery. While liftig it usually acts up with rep range of 8-10.
5) Once it starts it is usually constant until I stop the activity and then it goes away in 15 mins or so depending on how much i aggrevated it.
6) No
7) Range of motion is not an issue until after it acts up. Really acts up with SLDL, RDL, and hypers in a high rep range.
8) Leaning over, stopping the movement.
9) Main concern is there something wrong with the spine, disc or nerves and the long term effects.
10) I have been told I have flat hips and that I have tendonitis in my hips, but that has been good over the past year. Other than that no prior injuries.
I have been dealing with this for years as it goes away quickly. I finally went to the doctor when in lingered for a week. I have been taking advil and muscles relaxers for a few days and it feels pretty good. I have one spot on the right side about 3" from my spine that I have a sharp pain, does not hurt to the touch, but I think this may be the originator of the above mentioned problem.
If you need addition info please let me know.
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Those who want tolerance must be tolerant to intolerance.
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2007/07/17, 05:06 PM
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2007/07/19, 03:41 PM
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2007/07/19, 06:00 PM
Look guy dont worry about it. Not sure how this concerns you. I am seeking a professional opinion and also want advice from wrestler. I plan to share the info I receive from my DRs as well to help him in his studies. Lets keep this thread on point.
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Those who want tolerance must be tolerant to intolerance.
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2007/07/20, 01:42 PM
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2007/07/20, 02:02 PM
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2007/07/31, 05:40 PM
Part of the problem sounds like posterior pelvic glide. When you stand, is there an arch in your lower back, an where doees your belt point (up or down). If it looks like your back is flat and your belt line (from side view) is down or neutral, then that might be your problem. This is usually brought on by tight hip extensors (glutes and hamstrings) and lax hip flexors.
Try arching your back and bending forward at the waist. How is your range of motion? You can test psoas strength by bringing your knee above 90 degrees while standing. If you can't hold your knee above 90 for 30 seconds without leaning back, then you have problems.
My next step would be to test for kyphosis (forward head posture).
This, of course, is provided the problem is muscular and not skeletal. I would imagine it to be muscular since it occurs at the onset of activity, rather than loading. Also, I can't tell too much about the spine without and MRI. Shoulders and hips are easier to diagnose without imaging.
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SQUAT MORE ~Jesse Marunde
Mortal by birth.
Strongman by the grace of god.
Blood Guts Sweat Chalk
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2007/07/31, 07:38 PM
Thanks - I will check these things out and bring this with me to the orthopedic and have him check it out as well. I go on Thursday so I will let you know how it goes. Thanks again.
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Those who want tolerance must be tolerant to intolerance.
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2007/08/01, 03:56 PM
Nothing serious here, but pretty similar to KAs description.
1. Where does it hurt? Give as best a description as you can.
Low back, right sideAbout 3-4 inches above belt line.
2. How does it hurt? What kind of pain is it? Dull, throbbing, stinging, sharp, stabbing, acheing, etc?
Not real painful, almost a pinch or stab type of feel though. Not horrible but enough to know it is there and to stop when I feel it.
3. When did it start hurting? What were you doing at the time?
Alright, don't yell too much here but I was going for a DL max and shot my legs up too quick and pulled it all with my back. Since then it happens occasionally.
4. When does it hurt? While lifting, standing, sitting, stretching, etc.
When I'm in a strange back position during daily activities. But it can get there after 3-4 sets of DL or a real hard low back workout.
5. Constant, intermittent, when doing certain movements?
Mainly with twisting type movements, a quick jerk or movement can get it.
6. Does the pain radiate to other parts of your body?
No
7. Range of motion? What movements can or can't you do?
Doesn't limit anything, I just chose not to push it when I feel it.
8. What makes it worse, better?
Stopping the activity, or laying down helps if I'm at home.
9. What is your main concern regarding the pain and its consequences?
I don't want to further aggrivate it. It isn't horrible now, I want to keep it from getting that way and stopping my lifting progress.
10. Any prior injuries?
Nope.
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2007/08/01, 03:58 PM
Wow, that's harder to read than I thought it would be. I apologize for that. Try this.
1. Where does it hurt? Give as best a description as you can.
Low back, right sideAbout 3-4 inches above belt line.
2. How does it hurt? What kind of pain is it? Dull, throbbing, stinging, sharp, stabbing, acheing, etc?
Not real painful, almost a pinch or stab type of feel though. Not horrible but enough to know it is there and to stop when I feel it.
3. When did it start hurting? What were you doing at the time?
Alright, don't yell too much here but I was going for a DL max and shot my legs up too quick and pulled it all with my back. Since then it happens occasionally.
4. When does it hurt? While lifting, standing, sitting, stretching, etc.
When I'm in a strange back position during daily activities. But it can get there after 3-4 sets of DL or a real hard low back workout.
5. Constant, intermittent, when doing certain movements?
Mainly with twisting type movements, a quick jerk or movement can get it.
6. Does the pain radiate to other parts of your body?
No
7. Range of motion? What movements can or can't you do?
Doesn't limit anything, I just chose not to push it when I feel it.
8. What makes it worse, better?
Stopping the activity, or laying down helps if I'm at home.
9. What is your main concern regarding the pain and its consequences?
I don't want to further aggrivate it. It isn't horrible now, I want to keep it from getting that way and stopping my lifting progress.
10. Any prior injuries?
Nope.
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2007/08/01, 06:02 PM
That one's a little simpler.
Strained erector spinae, specifically the head of your spinalis.
No rotational movement. You don't need it anyways. If you want my explanation I'll give it to you on another thread, but stop it. Your trunk is meant for PREVENTING rotation. If you want to train rotational strength, try a single arm dumbbell press.
For rehab, time off from deadlifting. If you still want to deadlift, you could probably pull sumo, if you can keep a tight arch. Keep a double over grip, even if you have to use straps (for now). Make sure to finish the movement with your glutes (squeezing and pulling through), you don't want to trade erector pain for femoral anterior glide and hip joint capsule pressure.
Sleep with a pillow under/between your knees (if you sleep on your back/side). If you sleep on your stomach, stop. Static stretch your hip flexors a few hours after waking and before going to bed. Also, from now one, do some glute bridges before you train your lower body. This will get your glutes firing. In many cases, pulled hamstrings or erectors are due to poor glute function.
You're also going to want to do some soft tissue work for those erectors. I have to thank arondaballer for finding this page, as I typed 3 paragraphs explaining what to do, and then he found and told me about this article. From what he tells me, he is pain free for the first time he can remember, and this was one of the main things I told him to focus on: http://www.t-nation.com/readTopic.do?id=1259323
You'll be doing the thoracic spine exercises.
Now for prehab...
Side bridges at least twice a week. One day for endurance (2 sets max time) and one day for strength (3 sets of 45 seconds holding a weight at your hip).
Make sure you are not always using the same over/under grip when you deadlift. Change it up from time to time. And get a new pair of lifting shoes, I'd bet my lunch you're using sneakers.
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SQUAT MORE ~Jesse Marunde
Mortal by birth.
Strongman by the grace of god.
Blood Guts Sweat Chalk
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2007/08/01, 06:06 PM
Anyone reading or posting, I apologize if any of my responses sound like anatomy lessons, I try to be as specific as possible while still making it easy to understand. As always, if you have a question, ask...
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SQUAT MORE ~Jesse Marunde
Mortal by birth.
Strongman by the grace of god.
Blood Guts Sweat Chalk
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2007/08/02, 10:03 AM
Went to orthopedic, took a bunch of xrays which all looked good. Will have an MRI next week to determine if I have a disc tear. Dr. believes it is lumbar sprain/strain but needs to see MRI. Scheduled for PT 2-3 times per week for a month to work on stretching and range of motion exercises and core work. Core work I do, but the strenching - not so much.
I do have an arch in the lower back and I was able to do the standing test with no problem. Thanks again for your help, if you have any more thoughts or suggestions I would appreciate them. I will let you know what the MRI says and how PT goes.
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Those who want tolerance must be tolerant to intolerance.
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2007/08/02, 09:00 AM
No that was great, easy to understand but enough detail too.
Thanks for the advice, I'll let you know how it goes.
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2007/08/02, 11:24 AM
hmmm. I agree that it may be a strain, but I am trying to figure out WHY, seeing as this isn't a one time thing like ecle5c's injury. Since it has been happening for years, I would look to the root cause. Posterior pelvic glide would put you in a position where your lower back would be at risk, which is why I suggested it. Of course, this would be the first thing a PT would check for and would be obvious the moment you walked in the room, so you may be in the clear. Or, it might be something more indepth.
My only suggestions at this point is that when it comes to the muscularskeletal system, listen to your PT. An orthopedic can tell you what you did, but often can't understand the root causes (simply because this isn't what they are trained for). Understand I'm not saying your Dr. doesn't know what he is doing, but realize he gave you a 4 week diagnosis for something that has been happening for years. Your PT will look beyond this.
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Quoting from KA:
Went to orthopedic, took a bunch of xrays which all looked good. Will have an MRI next week to determine if I have a disc tear. Dr. believes it is lumbar sprain/strain but needs to see MRI. Scheduled for PT 2-3 times per week for a month to work on stretching and range of motion exercises and core work. Core work I do, but the strenching - not so much.
I do have an arch in the lower back and I was able to do the standing test with no problem. Thanks again for your help, if you have any more thoughts or suggestions I would appreciate them. I will let you know what the MRI says and how PT goes.
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SQUAT MORE ~Jesse Marunde
Mortal by birth.
Strongman by the grace of god.
Blood Guts Sweat Chalk
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2007/08/13, 10:56 AM
This is from the MRI paperwork:
Sagittal T1 and sagittal FSE T2 images were obtained through the lumbar spine. Axial proton and T2 weighted FSF images were obtained through the lower fours disc levels utilizing an array surface spine coil and GE Horizon 1.5 Telsa MR system
The signal intensity of the vertebral bodies and the visualized spinal cord are within normal limits. Each disc space is uniform in signal intensity and height and shows no significant abnormality except for minimal annular disc bulge at L5-S1 interspace. The central canal, neural formina and fecet joints are also unremarkable.
Minimal annular disc bulge at the L5-S1, otherwise normal MR study of the lumbar spine.
Orthopedic said that 40% of people with no back pain have this issue. At this point believes it is a muscular strain and to continue with P.T.
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2007/08/13, 07:37 PM
Basically your MRI is saying you don't have a herniated disc, spinal twist, or scoliosis. A small bulge at L5 (top of lumbar spine) is nothing to worry about.
You're basically normal, which leaves us with muscular pain. Therefore, it IS most likely muscular.
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SQUAT MORE ~Jesse Marunde
Mortal by birth.
Strongman by the grace of god.
Blood Guts Sweat Chalk
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2007/09/28, 02:41 PM
My experience with a number of patients with back pain is that they demonstrate a pelvic obliquity, often described in literature as an inflare/outflare. Most will present with the right iliac crest higher than the left and the sacroiliac joint rotated anteriorly.
When I see this, I notice these other things:
1. Apparent leg length discrepancy, right longer than the left (not a true LLD though).
2. Arches not symetrical, usually the right lower than the left to compensate for the longer leg.
3. Passive single knee to chest, knees move aymetrically, one straight up, the other out (I'm more concerned with the asymmetry than what they actually do).
4. Mild scoliosis in standing (not a true scoliosis but rather due to pelvic obliquity).
5. Pain may or may not be asymmetrical but is often one sided because of the additional strain on one side.
I can usually correct this with some muscle energy, >90% of the time resisted Rt hip extension with Lt hip flexion (in a scissoring pattern). When I find this, it usually is a major contributing factor and doing this one thing eliminates most of the pain.
A close friend and colleague emailed me this morning and told me about a patient who was experiencing limited neck (yes, I did mean neck) motion and pain for about 7 mos. He noted this pelvic obliquity and corrected that, restoring full neck motion and eliminating the neck pain.
Just a good thing to remember that location of the pain and the source of the pain may not be the same. That's why PTs ask for a detailed history.
Might be worthwhile having your PT check this out. If it is it is easily treatable.
I believe in KISS...keep it simple stupid! Good luck.
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Kip
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2007/09/28, 03:53 PM
Kip is on the right track (I would say the vast majority of back pain presents with pelvic impairments), but as you can see, without a physical examination, most of this is not apparent (most patients don't even know where the iliac crest is, let alone if it is symmetric on both sides...)
This is why AN EXAMINATION IS ALWAYS BEST.
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SQUAT MORE ~Jesse Marunde
Mortal by birth.
Strongman by the grace of god.
Blood Guts Sweat Chalk
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2007/10/22, 01:39 PM
I'm back and not for good reasons.....
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1. Where does it hurt? Give as best a description as you can.
Low back, right side just right of the spine about 4 inches above my waist.
2. How does it hurt? What kind of pain is it? Dull, throbbing, stinging, sharp, stabbing, acheing, etc?
Throbbing and stabbing this morning, took some tylenol and stretched a little and now it is dull and achy for the most part. If I do something too quick though the sharp stabbing comes back.
3. When did it start hurting? What were you doing at the time?
I moved a piano last night, the help on my side bailed and rather than f-up my hardwood floor I finished carrying it another 10 feet. My back was sore after that, like after heavy deadlifts but this morning I couldn't hardly get out of bed.
4. When does it hurt? While lifting, standing, sitting, stretching, etc.
Constantly a dull pain, when I bend down or engage my lower back it is a sharp pain. Haven't tried lifting yet.
5. Constant, intermittent, when doing certain movements?
Constantly dull, sharp when doing certain activities.
6. Does the pain radiate to other parts of your body?
I feel it down my hip and almost into my leg when it really throbs.
7. Range of motion? What movements can or can't you do?
If I'm conscientious about it I can do about anything slowly, but quick bending down, etc. is a no go.
8. What makes it worse, better?
Tylenol, stretching helped slightly.
9. What is your main concern regarding the pain and its consequences?
Future lifting, ongoing recurring back problems.
10. Any prior injuries?
Read above in this thread, I had a slight tweak while DLing a few months back. I did the exercises suggested and that helped a lot. I haven't DL'd since, rack pulls a few times but not all out. I do SLDL regularly though, not ME though.
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2007/10/22, 02:11 PM
Hey, out of curiosity, wrestler125, what new career are you practicing for?
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2007/10/22, 11:04 PM
Any bruising at all along the anterior iliac crest (back, top of pelvis)?
Sounds like the same thing. This time, I'd say continue following my suggestions, but see a physical therapist for a review. Healthy individuals don't have this problem over and over again, you have some form of movement impairment most likely. A manual review is mandated in this case.
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SQUAT MORE ~Jesse Marunde
Mortal by birth.
Strongman by the grace of god.
Blood Guts Sweat Chalk
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2007/10/22, 11:06 PM
I'm currently undertaking a dual degree in industrial engineering and biomechanics. My focus is to be human factors engineering, specifically biomechanics and ergonomics. While I do not have an extensive education, I am well practiced with regards to movement impairment syndromes and the human body, and have spent enough time under the bar and MRI that I can relate my education to lifters.
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Quoting from wasakat:
Hey, out of curiosity, wrestler125, what new career are you practicing for?
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SQUAT MORE ~Jesse Marunde
Mortal by birth.
Strongman by the grace of god.
Blood Guts Sweat Chalk
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