Back rehab and starting over

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cubejockey_81
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Back rehab and starting over

Post by cubejockey_81 » Fri Mar 27, 2015 3:14 pm

Several years of commuting 2 hours a day and sitting on my ass in front of a computer seems to have suddenly caught up with me. For two weeks I've had sciatica pain, starting in the left lower back, running down my hip and into my lower leg. Never had it before. Makes sitting in a car absolutely suck, tough to get out of bed, and the transition from sitting to standing hurts like hell. Only feels better after walking around for a bit. Bad enough that it's tough to focus at work and on other things.

Not overweight, 34 years old, 5'10, 187 pounds, I'd say ~15% or so bodyfat. Training history is spotty at best. I've made several runs at the standard Starting Strength model (GOMAD included for a couple of them, which was stupid) but tend to top out in the mid-high 200s for squat, high 100s for bench, and high 200s for deadlift before crapping out or going on a layoff due to other obligations. Was working at it for the upteenth time before the sciatica showed up.

Going to take a different route for awhile. First priority is to get the sciatica under control. My wife has the full DDP Yoga series and enjoys it, so I'm going to give the yoga thing a shot and see if it improves anything. Not sure at this point how I'm going to work strength training back in. I can squat and dl just fine with the empty bar when the back and hip are warmed up and stretched out, but haven't been willing to load the bar up since the sciatica kicked in. Taking another crack at SS at this point is probably a waste of time, so I need to figure on some other way of doing things.

Goals for this log:
1) correct the sciatica issue
2) figure out a long-term strength training approach - might go look through Pavel's or DJ's stuff
3) maybe try to un-teach myself the SS squat I've used so much and learn how to highbar correctly again
4) when things are straightened out, put on some muscle, esp. in upper body - all the SS attempts have left me with big thighs and not much else
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Re: Back rehab and starting over

Post by cubejockey_81 » Fri Mar 27, 2015 3:20 pm

3/26/15 Went through the DDP diamond dozen dvd. Learning the movements. Chick in the yellow top with big cans is hawt.

3/27/15 Practiced the diamond dozen this morning in the little gym we have at work. Back hurt getting out of bed and on the commute. Felt a little better after the w/o, is more of a dull ache reaching down into the lower leg while sitting here at work. Standing up sucks.
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Re: Back rehab and starting over

Post by cubejockey_81 » Sat Mar 28, 2015 7:33 pm

DDP diamond dozen
DDP 'energy'

Energy is basic DDP workout. Found a few elements challenging and was sweating pretty good by the end of the 20 mins.

Sciatica awful this AM, standing up and walking around didn't alleviate like it usually does. Sharper in the hip this time. Immediately downed 800 mg ibuprofen and have been working ice and heat on it throughout the day.
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Re: Back rehab and starting over

Post by bennyonesix » Sat Mar 28, 2015 10:52 pm

Mackenzie talks about remote pain moving up and to the midline as a sign of improvement.

Is that what is happening?

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Re: Back rehab and starting over

Post by cubejockey_81 » Mon Mar 30, 2015 2:07 pm

bennyonesix wrote:Mackenzie talks about remote pain moving up and to the midline as a sign of improvement.

Is that what is happening?
It migrates. Some days it's right at the hip joint, others in the lower back, oftentimes both. Trying to eliminate causes...slept on couch last night instead of bed, no improvement so that's probably out. I think the real trigger is sitting in the car. Pain is sharper when I try to hinge forward, esp. with weight, but I can squat ATG no problem.
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Re: Back rehab and starting over

Post by cubejockey_81 » Mon Mar 30, 2015 2:14 pm

3/30/15
Light stretching
Highbar ATG squats, unweighted then with bar, several sets of 3, 5 and 10 (wasn't really counting). Watched a few Catalyst videos for tips over the weekend. All the Rip-style squats have made my hamstrings and glutes really want to take over out of the hole - have to focus a little to get quads to do what they need to. I sink into the hole and get bounce much more smoothly with the highbar, though.
Bench 175 3x5
Couple of half-assed yoga movements trying to stretch things out - back/hip stiff and painful today.
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Re: Back rehab and starting over

Post by bennyonesix » Mon Mar 30, 2015 2:35 pm

cubejockey_81 wrote:
bennyonesix wrote:Mackenzie talks about remote pain moving up and to the midline as a sign of improvement.

Is that what is happening?
It migrates. Some days it's right at the hip joint, others in the lower back, oftentimes both. Trying to eliminate causes...slept on couch last night instead of bed, no improvement so that's probably out. I think the real trigger is sitting in the car. Pain is sharper when I try to hinge forward, esp. with weight, but I can squat ATG no problem.
Do you do the Mackenzie exercises? Any extended time in Savasana? Time in inversion?

I really really hesitate to recommend this but it eases the symptoms in my back so here goes:

I lay on my back with my feet flat on the floor and rest my weight on a foam roller (actually PVC but I am mad) on the lowest facet of my back until it releases and then move up to the next facet and repeat etc. I can really feel the release each time if I am patient. This is probably uber retarded but there it is...

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Re: Back rehab and starting over

Post by cubejockey_81 » Wed Apr 01, 2015 1:28 pm

I'm thinking of giving the foam roller a shot - don't have one currently. Also thinking of picking up the Foundation Training book based on info here.

3/30/15 (evening) - Mackenzie drills at home. Managed to isolate the pain to my lower back. Iced for 20 minutes laying on my back with feet up on a chair, 10-15 minute break, then ice while in bed before sleep.

3/31/15 - Same as 3/30/15.

4/1/15 - HOLY FUCK. Pain shooting through the hip, knee, and lower leg. Sitting here at work trying not to scream waiting for 400 mg ibuprofen to kick in and ice on my back. Mackenzie drills this morning, but had trouble moving pain into the lower back - kept aggravating my hip. Worst pain is from left side of patella down through left side of shin.

Some very light bodybuilding stuff - seated db press, db curls, cable row, pulldowns. Also tried some Foundation Training back extensions from youtube.

Thinking of paying a visit to a doctor. I haven't been to a doctor in 9 years (yeah, I'm one of those idiots), but this is getting out of hand.
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Re: Back rehab and starting over

Post by TomFurman » Wed Apr 01, 2015 4:53 pm

McKenzie and Dr. Stu McGill's stuff is priceless. Foundation is an ongoing formula.
Racked carries, from my experience, seem to help a lot. One sided that is to stimulate the quadratus.
However see a Doc or Chiro. [I'm not big on Chiro's generally speaking].
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Re: Back rehab and starting over

Post by bennyonesix » Wed Apr 01, 2015 5:06 pm

I had same problem it sounds like. My neck went haywire too.

The best thing is getting a different job/career but...

I could deal if I maintained a 1 to 1 ratio of sitting to movement over the course of a day.

I started with slow walking... Then added twists etc while walking slowly and then worked up to cals...

McKenzie was the only static type stretching I could tolerate... Mobility stuff done stupid gently was much more effective.

This sounds weird but I swear that slow strict form high rep bw leg work (box squats, lunges etc) was very soothing.

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Re: Back rehab and starting over

Post by cubejockey_81 » Thu Apr 02, 2015 1:23 pm

Thanks Tom and benny. I'll add racked carries to the repertoire and try to get out of my chair at work more frequently.

4/1/15 (evening) iced my back 20 on, hour off all day, and put an ice bag behind my back for the commute home. Made the drive much more manageable.
Mckenzie drills, 8 reps in 30 seconds sphinx, 30 seconds rest, 30 seconds cobra format.
Foundation Training back extensions, 3 sets of 12 reps.

Also tried the "Founder" from FT from a youtube vid for 4 reps. This made things feel one hell of a lot better - I'll be adding the exercise daily.

Going to keep DDPYoga out of the mix for awhile (only did it 2-3 times anyway) - it's a little too aggressive at the moment. Mckenzie and FT exercises are the order of the day.
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Re: Back rehab and starting over

Post by bennyonesix » Thu Apr 02, 2015 1:44 pm

My back likes alternate heat and ice waaaaaay more than just ice. It also likes the below stretch:


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Re: Back rehab and starting over

Post by nafod » Thu Apr 02, 2015 2:47 pm

I bet if you had your back x-rayed you would see the results of long term degradation, of which the recent sciatica was the tip of the iceberg. Your back has silently been degrading, and you are just now "hearing" about it. Could be wrong...

What does this mean? Fixing the back is a long term project. No short term fix and then getting back to life as it was. Even if you solve the pain problem, there's probably still underlying structural deficit. That's my story. Even if it is not exactly yours, no harm in being back-smart from here on out. Think hard about what got you to this point, and acknowledge that inputs must change if you want outcomes to change.

It took years for mine to essentially recover, and I've got some weird scoliosis now due to vertebra getting crushed and reconstituting that evidences itself in gait and flexibility. But the pain is gone, yay!

Things that helped me...
- Rolling out of bed and doing push-ups first thing in the morning. Ease into the depth of the pushups, as it is not really about the arms and shoulders. It compresses the spine and works the core. See McGill for why this helps. also...
- Doing the chair pose first thing in the AM. Just very gently working down into it, focusing on form while letting range of motion slowly increase. go for 1 minute then 2 minutes of static hold. Iso strengthening around the core is ALWAYS GOOD.

Image

Rack pulls and just carrying stuff. For example, I had to wear 50 LBs body armor daily for three weeks while back was fubar, as I lied to the flight surgeons about it. Turned out to be a positive experience!

This book has a ton of good stuff, due to bikers being kind of like office workers in neglecting their backs and having bad posture. You can probably steal most of the good ideas just standing at Barnes & Noble and scanning the back health chapters.

Image

Sorry for spamming your thread!
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Re: Back rehab and starting over

Post by bennyonesix » Thu Apr 02, 2015 5:07 pm

Sorry but I am going to keep up with the spamming.

I had a diametrically opposed approach (not saying yours was wrong). I got myself to accept/believe/whatevs that there was no underlying injury but that my back muscles were just exhausted and that my posture/movement/lifestyle were keeping them that way. I got to the point where I could feel the weakness/exhaustion when I was getting out of a chair and up off the ground or picking something up. And I gauged improvement by how strong my back felt during the day as I did those things...

One of my reasons was my experience that there is very little correlation between visual evidence of degeneration in the back and symptomology (either way actually). Person A can have a terrible looking x-ray and be pain and symptom free whereas someone else can have a nice x-ray and manifest sig pain and symptomology...

While I am at it, I accepted/acted as if it were true that there is a strong correlation between mental/emotional/psychological health and back issues. I got on my life shit and got back on track and honestly that seemed to help.

And well hell, while I am at it, I will add the most embarrassing thing... I come from a family of orthos/surgeons and they all say that touching/manipulating the patient is the one thing that distinguishes between consistently good results and meh results... So, I went and got massages on the theory that the physical touch and manipulation would help. Needless to say I soon found a hottie which well... she was great. heheheh

Sorry again for the spamming.

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Re: Back rehab and starting over

Post by cubejockey_81 » Fri Apr 03, 2015 2:57 pm

Thanks Nafod and benny. Spam away. Need all the igx knowledges I can get.

Tallying up the activities over the years - throwing ammo boxes and humping packs in the Corps and rowing in college all followed up by on-again-off-again strength training with no running, stretching, or otherwise to balance it out, mixed in with years of sitting in a car in traffic and all day at work, I should be surprised it took this long for problems to show up. As to whether I'm looking at long-term degradation or a temporary blip, I'll leave to the experts. Either way, you're correct Nafod - this will be a long-term project and I have a few habits/behaviors that will need to change permanently.

There's a spine therapy clinic just down the road from me that's in my insurance provider network, so I'm going to stop in and see what they have to say.

4/2/15 (evening)
Mckenzie drills, 30s sphinx/30s rest/30s cobra, 8 reps
FT back extensions, 3 sets 12 reps
FT Founder, 5 reps (looks the same as the chair pose Nafod posted above) - this really helps

Iced throughout the day, on the commute, and before bed. Will work in heat as suggested.
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Re: Back rehab and starting over

Post by cubejockey_81 » Sat Apr 04, 2015 5:57 pm

First visit to a chiro today. Something going on in the L4 with the disc - chiro said they can't diagnose exactly without an MRI, which they don't believe is necessary and will avoid until we've run a course of treatment.

A couple of adjustments to lower and upper back (sort of a fairly hard and quick push on the upper back and a rotation and push on the lower - honestly have no idea what the chiro was doing), followed up by ultrasound heating and then these little electrical pads to heat the general area. I could walk a little better after, but no real improvement to the pain. I'll go a few more times and see if things improve. I was told to continue the Mckenzie drills, ice and heat, ibuprofen as needed. I go back Tuesday evening.
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Re: Back rehab and starting over

Post by cubejockey_81 » Mon Apr 06, 2015 12:17 am

Mckenzie drills, 30s sphinx, 30s rest, 30s cobra, 4 reps. Another 4 in same format but holding poses for a minute.
FT back extensions, 3 sets of 15 reps.
FT Founders, 4 reps.

Heat pad on back all day.

Marked improvement after chiro visit. Pain is still present but much more manageable. Able to walk with a more normal gait. Next appointment is Tuesday evening.
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Re: Back rehab and starting over

Post by cubejockey_81 » Tue Apr 07, 2015 10:39 pm

4/6/15
12-hour heat pad throughout the day.
McKenzie drills, 30s sphinx - 30s rest - 30s cobra, 8 reps
FT back extensions, 3 sets of 15 reps
FT Founder, 5 reps

Still feel ok - better than I have been. A little tight and sore getting out of bed. Still limited range of motion in the leg, but pain is overall much more manageable.
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Re: Back rehab and starting over

Post by cubejockey_81 » Tue Apr 07, 2015 10:41 pm

4/7/15

Second visit to chiro. Same treatment as first visit.

Leg/back pain like to flare up when driving. Major point of pain is just below knee and into the shin. Chiro says that's to be expected with L4 issues.

Overall not too bad pain-wise today.
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Re: Back rehab and starting over

Post by cubejockey_81 » Fri Apr 10, 2015 12:50 am

1 min sphinx, 30s rest, 1 min cobra for 8 reps
FT back extensions, 3x15
FT Founder, 3 reps
push-ups x 10

It's been angry at me the last couple days. Concentrated in hip and shin. I can get it into my back for awhile but sitting and driving shoot the pain right back down my leg. Third visit with chiro tomorrow.
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Re: Back rehab and starting over

Post by DikTracy6000 » Sun Apr 12, 2015 11:23 am

I don't know shit, but had similar experiences with back and sciatica from my mid 20-s to mid 30's. too much sitting at work, too tall(Ortho's words), unstable back, one leg shorter than other, blah blah blah. I got six accupuncture treatments and it helped pain a good bit, but wasn't the cure. I gave up squats and was able to be on feet more at work being a plant engineer. Fortunately didn't have long commutes until recently. Except for recent circumstances I've been deadlifting moderate to light weights for reps for the last decade. Best rehab exercise for me was deadlifting a broomstick with perfect form, when I was in my most miserable condition and try to stop sitting too much. Don't know what to do about long commutes in your case. Good Luck!

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Re: Back rehab and starting over

Post by cubejockey_81 » Mon Apr 13, 2015 3:24 pm

Thanks Dik. I'm planning on working in some very light barbell stuff here soon. Think I'm going to focus on front squats and sldls for awhile - the first to get out of the SS-style squat habit, and the other to get a good stretch through the spine and hammies.

Back has behaved a bit the last couple days. It's up and down. Major pain still likes to focus in my shin, just below the knee. Using a lumbar support at work that somebody gave me and that helps. Heat application and small doses of ibuprofen are the major improvers.

4/12/15
Lazy over the weekend. Spent most of it on the couch.
Found a more thorough description and progression for the McKenzie drills on the net. Performed the drills last night. Helped quite a bit more than just the standard sphinx and cobra. I'll list the progressions in the next post in case anyone's interested.
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Re: Back rehab and starting over

Post by cubejockey_81 » Mon Apr 13, 2015 11:51 pm

For reference:

MCKENZIE BACK EXTENSION PROTOCOL (Robin McKenzie. “Treat Your Own Back”)
1)Prone lying: Patient is in a prone position with arms along their sides and head turned
to one side. This position is maintained for 5 minutes.
2)Prone lying on elbows: Patient is in a prone position with weight on their elbows and
forearms and their hips contacting the floor or the mat. The back is relaxed to allow
contact with the floor or the mat. This position is maintained for 5 minutes. If there is too
much pain, then this position is stopped and the patient retreats to exercise number one.
3)Prone press ups: Patient is in a prone position with weight on their palms which are
close to the shoulders. The patient slowly pushes the shoulders up, keeping the hips on the
surface and the back and abdomen relaxed. The maximal height is maintained for 5
seconds and repeated up to 10 times per day.
4)Progressive extension with pillows: The patient is prone and a pillow is placed under
the chest for about 3 minutes. A second pillow is placed after 3 minutes. If there is no
significant pain, then a third pillow is added after 3 minutes, and this position is held for
another 3 minutes.
5)Standing extension: With the patient standing with their hands on the small of the
back, the patient leans backward and holds this position for 20 seconds. This is repeated
up to 10 times per day.
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Re: Back rehab and starting over

Post by cubejockey_81 » Tue Apr 14, 2015 2:50 pm

4/13/15
Mckenzie protocol as listed above. Also a couple fingers of Maker's to take the edge off after the commute home.
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Re: Back rehab and starting over

Post by bennyonesix » Tue Apr 14, 2015 11:41 pm

You seen this thread? Good stuff...

http://irongarmx.net/phpBB2/viewtopic.php?f=2&t=227196

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