Pulled a Muscle in my Back

[Júlíus G. Magnússon]

I'm thinking a lot of you might have real experience with back injuries. I've had several conflicting opinions by people on what I should and shouldn't do and would love for someone with real experience with a back injury for someone at a high activity level.

Long intro (feel free to skip down to the short intro): Almost three weeks ago (20 days, now), I think I pulled a muscle in my back. I was a bit too ambitious on my deadlifts, and on my last rep of a set of five with 135kg, I could feel my form deteriote. I didn't experience any pains immediately, but two days later it was time for my squatting session. 3x5x110kg.That was a Thursday. The first set started with a slight discomfort, the last set felt like crap. The next day I was very sore and had trouble picking things up, et cetera. When Sunday rolled around, I had a metcon workout. "Fran" with 52,5kg thrusters. That evening my back felt like complete shit and kept feeling like shit throughout the week.

Short intro: I pulled a muscle in my back three weeks ago.


Long story (feel free to skip down to the short version): I asked around and different people gave me different suggestions as to how I should treat my back. I started out taking Ibuprofen for a few days. It made sleeping more bearable. The first week, I didn't do any exercising (safe for strict pull-ups and strict ring-dips). Spent some time in the hot tub (which seemed to make me feel worse later in the day).

After a week, Monday (8 days after "Fran"), I had a gymnastic session. I was feeling better, but a lot of movements still felt painful. Couldn't do anything resembling an L-sit for the life of me. After doing front flips for a few minutes, I felt like something in my back was starting to swell up. I had to call it quits and the next day I could barely move at all.

This was one week ago. I bought a cold gel pack, to put on my back. I do a lot of sitting at work and have been applying it every now and then through out the day.

I'm still resting now. Did one air squat yesterday to see if I could. I could, with a mild feeling of pain.

Short story: I rested for a week then hurt my back again exercising and felt worse than I ever did the day after that. I've been resting since then and It's been now and I'm starting to feel a little better.

How should I continue my treatment? When should I start working out again and how? When can I expect to feel healed?

The cold gel packs felt like they were doing me good at first, but I honestly don't feel them do anything right now. That's basically the only thing I'm doing for my back, except for making sure not to put any unneeded stress on it. Right now, the pain (or constant discomfort rather) seems to be more on the right side, extending from my lower back down a little beyond where my spine ends.

I'd appreciate any and all input on this.

Thanks.

[Allen Yeh]

If something has been hurting like this for 3 weeks now, I would possibly consider seeing some kind of medical professional?

[Júlíus G. Magnússon]

It's not like I've just been sitting around for three weeks... The first week was me gradually messing myself up more and more. The second was rest followed by going to fast, too soon, and then the third, again rest.

[Allen Yeh]

It's not like I've just been sitting around for three weeks... The first week was me gradually messing myself up more and more. The second was rest followed by going to fast, too soon, and then the third, again rest.

I didn't say anything about sitting around? I'm saying that if has been hurting for this long perhaps a visit to a sports doc might be in order.

Mark Rippetoe has a good write up on how to rehab certain types of lower back injuries. I've never done it only read what people have experienced using what he recommends.

[John Alston]

How about a psychologist?
Ok, kidding, sort of. I've done the thing where you take a slightly messed up issue and make it worse by not taking enough time off myself. It can be hard to make one take time off for as long as needed.
Did you do that rehabd routine with the light dl and stuff? Try doing a rehab routine - for a couple weeks, man. Seriously. One week is not that long recovery from even just a tweak. Gymnastics could easily tweak it again.
You probably need to strengthen an area, work on motor patterns, and all that crap, so block out some time for it and consider it a long term investment.

[Allen Yeh]

Courtesy of Jay Cohen's blog which lead me here -
The Bill Starr routine: http://ditillo2.blogspot.com/2008/06/rehabilitating-lower-back-bill-starr.html

[Júlíus G. Magnússon]

John, yeah, it's really hard to hold back. Especially since it's not really painful anymore, but a dull nagging discomfort more like it.

Allen, thanks. I had heard Rip talk about the Bill Starr rehab routine on Strengthmill, but never actually knew what the routine was.

I've been doing the halted deadlifts and good mornings now with a broomstick and I'll definitely be keeping that up. Thanks.

[Júlíus G. Magnússon]

Update: Here I am a month later after a bazillion reps of broomstick good mornings and very light deadlifts and squats.

The past few days I've been trying to gauge my limits. Did handstands on the floor and rings, swings on rings and bars, front and back flips, push jerks and power cleans up to 70kg and some 40kg thrusters.

I didn't feel the least bit bothered in my back during (or after) all this. The one thing that did hurt was trying to do an L-sit, and I was thinking that was probably because of flexibility loss more so than from my back injury.

I've got two questions, though, if someone has some opinions, please share them.

1. My back's feeling pretty good, except when I'm sitting down for a more than a few minutes. That's when I start experiencing a dull kind of pain. Nothing unbearable, just uncomfortable. Does anyone know what this is or have any ideas of how to deal with it?

2. What direction should I take my rehabbing in? I feel like I'm ready to start going heavy again, but I also don't want to rush things and have to start from scratch again. I was thinking some low intensity gymnastics and keep going for high rep squats, deadlifts, and add thrusters maybe, and gradually add weight for the next month or so, before starting full force again. Does that sound reasonable to you guys, or am I being too conservative?

[Garrett Smith]

Sounds like lumbar flexion is not treating you well right now (pain from sitting and L-sits, for most people these involve lumbar flexion). This could be a sign of a bulging or herniated disc.

I'd suggest you consider avoiding the ballistic gymnastics stuff and stick with strength moves.

Thrusters, due to the weight location and inevitable fatigue, will likely flare your back issue for a good long while (due to lumbar flexion). I'd suggest no exercises where you go into lumbar flexion AT ALL. Perfect form on everything is the prescription here.

There is no such thing as too conservative when we're talking about a month out from a back strain. CFers often don't understand what conservative means, note the injury forum for examples.

Work on hip flexor and hamstring flexibility while actively maintaining the lumbar lordosis.

I'd suggest breaking up the idea of thrusters into low rep sets of front squats and strict/push presses for now.

[Jordan Glasser]

Sounds like lumbar flexion is not treating you well right now (pain from sitting and L-sits, for most people these involve lumbar flexion). This could be a sign of a bulging or herniated disc.


Exactly what it sounds like to me too.

[Gittit Shwartz]

Damn... the same thing just happened to me. Complete with tingling down the right quad. First stop, chiropractic.
Hope you heal up fast!

[Craig Brown]

As noted in my unanswered plea for any help with Psoas (hip flexor) problems- the one thing I have learned from a year of this is that rehab must happen quickly, and thoroughly. My ART guy has me on a few standard hip flexor stretches, which I do every hour. It is helping a ton. Looking through the journals (my training logs) I can see what exercises and stretches are missing when this flares up- they will not be left out in the future!

Lastly, see someone and get your posture checked out. That's a big problem. I sit poorly and sleep outright wrong for what ails me. Working on it.

[Júlíus G. Magnússon]

Thanks for the comment, guys.
Sounds like lumbar flexion is not treating you well right now (pain from sitting and L-sits, for most people these involve lumbar flexion). This could be a sign of a bulging or herniated disc.

Bulging or herniated disc sounds serious... Should I go get checked out by a doctor?

According to WebMD 50% of people recover within a month... It's been almost two months for me. I was wondering how quickly and how accurately a doctor can diagnose a herniated disc? If I should go to the doctor to check things out or if I should just continue my rehab, assuming that a herniated disc is the case?

[Garrett Smith]

Whether you choose to go mainstream or alternative/complementary, you should at least go see a professional soon to get a better idea of what you are dealing with here.

[Júlíus G. Magnússon]

Thanks a ton for the replies, Dr. G. I'll go see a doctor first thing next week.