Sunday, April 19, 2009

Herniated Discs! L4-L5 & L5-S1 Advice

Before I tell my herniated disc story and give some advice, you should know a little about me. I am basically done my bachelors degree in Exercise Science from West Chester University (PA). I have a concentration in sports medicine and a nutrition minor as well as a pending coaching minor. By no means does this mean you should heed my advice as gold. I am simply telling my story and would like to offer advice/sources to anyone else with similar problems. In turn I would like advice from those who are functioning highly with herniated disc(s) or similar back problems. Now to my story.
I was getting real into olympic lifting and crossfit. Actually, I had just gotten certified in both. During the crossfit deadlift workout 5x5x5x5x5 I felt a pull in the lower back. The pain crept up and I had to stop deadlifts and finished the workout with a few squat cleans without much of a problem. The next day the pain was HORRIBLE. I applied the RI of RICE (rest and ice) gave it two weeks and then let my ambitions of posting better and better crossfit scores get the best of me. Cleaning, squatting and deadlifting again only degenerated the discs more. After a few months I had enough of my deteriorating workouts and scheduled the appt. with the doc. My MRI revealed 2 herniated discs at l-4-l5, and l-5 - S1. The back specialist said L5 - S1 was an old injury that got re-aggravated. A few weeks later when I got the pain in my hamstring that had nagged at me for almost a year after I pulled it terribly during football season I remembered precisely when I injured the L5-S1 disc. Looking back, i can't believe I dismissed my back pain and subsequent sciatica to the after affects of playing football on a pulled hamstring.

So now I have fully backed off the exercises and movements that make the back pain worse. I have refrained from squats, deadlifts, and forward flexion. Essentially I avoid anything that causes pain, even sitting. I do try and walk often, stand, lie down (with the spine neutral). As for exercise I  have avoided running because of the pain in my hamstring which has recently died down and went back to the disc area. I do a lot of pull-ups, presses, push-ups etc... I bought a reverse hyper-extension from the good folks at New York Barbells. I  use it almost daily, performing light weight reverse hyperextensions for high reps gets the back feeling good. Anyone suffering from a herniated disc with aspirations of performing at a high level again would be interested in the Louis Simmons story. In short, Louis Simmons was a powerlifter with several herniated discs, bones spurs and cracked vertebrates. Dr's were recommending a spinal fusion and disc replacements back in the late 70's early 80's. Louis knew this would end his lifting career so he opted to rehab his own back, he developed the reverse hyperextension and today has 3 patents and sells the machines off of his website. They were out of my price range so I went with the newyorkbarbells version. (on sale for 400). It also acts as a GHD (glute ham developer) Where I perform GHD sit-ups and back extensions. I feel these exercises are great for herniated disc rehab and prehab. Most people have herniated discs. The people who present with pain generally have week hip flexors and abdominal muscles as well as tight hamstrings. I am definitely guilty of tight hamstrings. However, GHD sit-ups ensure that the hip flexors and abdominals are not weak. 
This tool has been indespensible in my back rehab. I feel like it got rid of my sciatica fairly quickly and has allowed me to keep my strength in my legs and especially core. What this machine does is it tractions the spine, correcting muscular imbalances that can predispose a disc to injury. Essentially it claims to straighten your spine out. My chiropractor says that its nearly impossible to herniate a disc if your spine is in alignment. The most important thing the reverse-hyperextension will do for your back is spinal decompression. It allows the discs to decompress and lets oxygen and nutrients get to the disc more readily, which in theory should help speed up recovery time. 
So in summary to help heal your lumbar herniated discs don't sit often. When you do sit, sit with proper posture, 90 degrees at the knees, back firmly planted into the back of your chair, weight evenly distributed on each buttock. Walk often, bounce on a bouncy ball or trampoline lightly. Stretch the hamstrings, strengthen the abdominals and hip flexors. Work on glute activation exercises, buy a reverse hyper-extension and perform high rep, low weight reps daily. Ice your back when  you are done. Warm it up before going into exercise. See a chiropractor and make sure you spine is in-line. 
Thanks for reading. Please respond with your own story/ any tips/ resources/ questions.


  1. This is crazy I feel like you wrote my story. I injured my l5-s1 because of poor form on oly lifts during crossfit. It's not crossfits fault it's mine! Not keeping a tight midline will hurt you! I just had an esi today to get rid of the sciatica in my right ass cheek and only 12 hrs into it I'm feeling better! I'm going to try the reverse hyper and ghds. Really sucks that I have to cut out everything that I've grown to love (daily rx'd wods) but like the doc says "you only have one back"!

  2. hey :) how is your back doing currently?