Training Around Bad Backs

Its no secret that a sneeze took my back out in November, and I’ve been rebuilding it ever since. It hasn’t been a fun trip, but it has taught me a lot, and has transformed a lot of my views on how to train someone the right way.

 

Plus, there is  no way in hell I’m going to be “that guy” who can’t play with his kids because he’s a deconditioned mess. I will go kicking and screaming into the night, and since I’ve already decided to kick the crap out of this condition before it does it to me, its fate has already been decided. I’ve been told by three chiropractors, my doc and a PT that as long as I take care of myself and don’t “do anything stupid (which we will hold loosely in its interpretation!),” surgery is not something I will need.

 

My back isn’t 100%, probably won’t ever be, but it is pretty damn functional now, and here’s why: I have hammered my glutes into tear filled submission, strengthened my spinal erectors so I can deadlift a Mac Truck (Ok, so I’m no where near that strong. I mean, the mere fact that my name isn’t Albert-Sven VonMagnussen Painter the nors Viking strongman should tip you off to that.) and crushed my core (yes, there’s that word again).

 

For you see, your abdominal wall, erectors and glutes are all that stand between you and spinal column obliteration. Without these muscles functioning properly, you don’t stand a chance. These are the muscles that allow you to remain upright and keep your shoulders from bowing over and touching your thighs as you age. Since your spine doesn’t attach to any supportive structures, you better damn well take care of these muscles.

 

The worst about all of this is I’m riding BETTER right now than I did two years ago when my back was in “better” condition. The way I’m now training is the key. If it works for someone with significant L5/S1 disc degeneration/bulging/herniation and a smidge of annular tearing, imagine what it can do for you with a healthy spine.

 

But before we get into all of that kind of fun, let’s take a look at what the above mentioned disc injuries to get a better idea as to what it is we are dealing with here.

 

Disc Degenerations

This is typically categorized as “degenerative disc disease,” but that is incorrectly classified. The reason being is because you’ve got a good chance at curing a disease. With discs, once they start to degenerate, thanks to pushing the limits of my PPO coverage, I know that this can’t be reversed (although spinal decompression can help restore minor amounts of disc space). However, if you exercise the right way, you’ve got a good shot at haulting what’s going on.

 

Keep in mind, the over 50% of the population has spinal column disc issues but is a-symptomatic (Post Rehab Essentials, Dean Somerset.) This means, there is a good chance you’ve got degenerations and bulging, but since you don’t exhibit any signs, you would check out fine.

 

The discs in our spine are soft, compressible tissues that separate the vertebrae in our spine. Think of them as the suspension system for our backs that allow us to do all kinds of stupid things! Without them you couldn’t flex, bend, or twist.

 

Disc degenerations can take place anywhere in the spine, but are most common in the lumbar (low back) and cervical (neck) regions. The typical causes of degenerations include:

  • Fluid loss in the discs reducing the ability to act as shock absorbers due to their having a lessened ability to flex. This will also cause narrowing of the distance between vertebrae as the disc shrinks.
  • Tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material inside the disc (nucleus) may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments. Once this happens, life can get really crappy really fast. Trust me, I know this first hand and it was a horribly crappy. There is no other way to put it.
  • Lack of thoracic spine mobility. If you can’t maintain an upright posture with your rib cage, the elevated shoulders and compressed chest cavity break down your posture leading to a potential injury.
  • Repetitive stress activities like lifting objects with incorrect form. Insert repeated spinal flexion here.
  • The natural aging process can also get you here.
  • If you’ve got perennially tight hamstrings and calves regardless of how much you stretch, get your lumbar spine check. There could be more at play.

 

 Disc Bulges

“A bulging disc occurs when one of the discs between your vertebrae develops a weak spot and pops out beyond its normal perimeter. Interestingly, many people might have a bulging disc and not even know it, as long as the bulging area does not press upon surrounding tissues (About Bulging Discs, Laser Spine Institute).”

 

A dis bulge can heal itself with the right approach, but if it causes frequent nerve pain that radiates down from the injury, you may need a more aggressive treatment plan. Unfortunately, it depends on the severity of the injury.

 

Disc Herniations

A disc herniation is a more extreme disc bulge. It is a tear the outer, fibrous ring (annulus fibrosus) of an intervertebral disc allowing the soft, central portion (nucleus pulposus) to bulge out. This can put pressure on the spinal cord or the nerves exiting the spinal cord. When this happens, you can get radiating pain, loss of power and quite a bit more.

 

How do you treat these injuries?

While you can’t reverse the process, you can prevent it from getting worse. This includes:

Doing spinal decompression. This has been miraculous for my back, and it is incredibly effective in 90+% of the cases of people with bad backs. Just like it sounds, this methodology “pumps” the spine to get nutrients to a damaged disc, relieve pressure and restore more function. There have even been instances of people getting 1-3mm of space back in their discs from doing this. Dr Vid Jindal at the Spine and Sport Institute in Sunnyvale, Ca does this, and he is awesome.

 

We offer a very unique approach to our decompression treatments and make sure the patient is cared for as a whole by incorporating the proper deep tissue muscle work, nerve entrapment areas and corrective exercises to strengthen the weak muscles so the pain never returns,” says Dr Jindal. Click here for more information. 

 

Limiting the amount of time you sit. This is an activity that can change the hydration levels and shape of the discs and start the ball rolling on herniations, bulges and tearing. The reason being is because you are sitting in hip flexion causing an anterior pelvic tilt tightening things you shouldn’t (erectors, hip flexors, lats, pecs, shoulders, neck flexors) and lengthening things that will do in (glutes, lower abdominal wall, hamstrings).

 

DO. NOT. EVER. FLEX. THE. SPINE. This means staying away from most forms of crunches, several yoga and pilates poses, etc. The more you flex the spine, the more disc is “shoved” into the nerve canal. Do enough, and you’ll tear enough layers of the anulus and eventually the disc gets up close and personal with the nerves, and you start getting shooting nerve “fun” shall we call it. If you’ve ever had sciatica, you’ve experienced this type of enjoyment. That’s more of a nerve impingement from a tight piriformis, but you get the idea.

 

Get a proper bike fit. Ride enough with your spine in a flexed position, and you get the same thing.

Strengthen the hell out of your glutes, spinal erectors, thoracic spine mobility and abdominal wall. Do this enough, and life can get better pretty damn quick.

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THE COMMON SENSE FINE PRINT!

Never attempt any new exercises mentioned in the VelowReviews blog without a thorough evaluation from a physician, personal trainer, strength coach, athletic trainer, physical therapist or sports chiropractor.

 

 

  • Adam Klein

    Al – what you say makes good sense to me. However, one theme for Pilates movement is to maintain flexibility across the entire spine – not just in the lower back. What I’ve seen people do is over stretch the lower back when they try to stretch their hamstrings while the mid and upper back muscles are locked into place. The spine starts at the head and works its way down to the base – people need to regain mobiility from head to toe – not just in the lower back. I think that this is a major cause of the injury that you are describing.