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Shane Upchurch
09-14-2007, 02:40 AM
ive had this back pain in my right lower back for nearly two years now and just when I think im rid of it, it returns. Im trying to decide if I should go so a phys therapist, again, or try a chiropractor. I like the phys therapist and she helped it for a while but she doesnt want me doing any squats or full situps or back extensions, and that just isnt going to happen. Im not sure if crossfit lifting is hurting it or just irritating an old injury. Im pretty sure it has something to do with flexibility, though I have been doing a series of stretches for about 3 months now twice a day to try and loosen up the hamstrings and hips, but it seems like when I get to parallel in the squat my hips just get really tight and if I try to go further, especially with weight, that is where the back pain comes into play. It never hurts during the workout only after.

So any suggestions? Chiro or PT?

Thanks

Tim Newsome
09-14-2007, 08:41 AM
That sounds just like my back has been for a long time now (4 years?). Basically, if I don't work out at all then my back feels pretty good, but occasionally achy/tight. If I do work out regularly I'll inevitably hit a point where it really starts to hurt.

So I did the physical therapy, twice. It helps me get back to where my back is fine if I don't work out. Earlier this year I hurt again and called my primary care doctor asking what I can do besides just physical therapy. He sent me to a chiropracter who I've been seeing regularly. The big thing I've noticed since seeing him is that I recover from a painful state much faster than I used to. If I did something bad, it used to take a week or two to get back to my steady state. Now that can happen in just a few days. My chiropracter agreed we weren't making much progress beyond that, so he referred me to an egoscue physical therapist. That's what I'm trying now. The standard PTs gave me exercises to strengthen abs etc. The egoscue PT is giving me exercises that are supposed to push my body back into alignment. (Specifically, apparently my hips are twisted a bit, which leads to an uneven load on my back, which might lead to my back pain.) These exercises are about 25 mins in the morning, and 25 mins at night. Two weeks in, I can't say if they're helping yet or not. They sure worked magic on a nagging shoulder injury I also had.

Anyway, that's my story. Maybe it's helpful to you. I think your best bet is to decide that fixing your back is your top priority, more important than doing crossfit, squats, etc. Then try whatever you can until you find something that works. You might also be able to find a PT who is more likely to let you keep exercising. If you feel you've exhausted PT, then by all means give a chiropracter a shot.

Tim

Shane Upchurch
09-14-2007, 09:31 AM
Thanks for the info. I just called my PT and am going to try her again. She says it sounds like a bulging disc, Im not sure how that will affect my WOD'S but it doesnt sound good to me.

Shane Upchurch
09-14-2007, 05:21 PM
With the idea of a bulging disk in mind, has anyone that now practices crossfit had to heal from a bulging disc? Were you able to perform the WOD'S with the bulging disc? How long before it was healed? Any info at all would help remove the sick feeling in my stomach.

Matt DeMinico
09-14-2007, 06:29 PM
One thing to think about, I never had back issues (and don't anymore once I fixed this) until I tried rowing, but did it incorrectly. I tried rowing on too high of a damper setting (like TEN) and just strained some back muscles doing it. Just FYI if you're overdoing it on rowing or something similar, my pain didn't go away for almost two months of taking it easy on it.

Aileen Reid
09-14-2007, 07:29 PM
This sounds exactly like my problem. I went to see a musculoskeletal guy who does interdisciplinary stuff - mixture of chiro, osteo etc and he said my pubic symphysis was out and hence my left leg was 3 cm shorter and everything twisted when I tried to do stuff. He manipulated me, and has shown me how to do it. I go back next week to see him but so far so good.

I had been going to physio for ages and it did little.

Shane Upchurch
09-15-2007, 10:01 PM
Aileen can you explain in more detail what you mean by "manipulated" and him showing you "how to do it"? Did he give you stretches or exercises to help the condition? Did he tell you to stop doing squats, dl's, etc. until it has healed?

Aileen Reid
09-16-2007, 01:12 AM
In my case I went to this guy primarily because I have had a knee problem that prevents me from squatting etc for about a year now. I saw a sports med doc and then a surgeon, have had 2 MRI's and an arthroscopy but its just the same. Because one knee is RS the other is now playing up. SO, becuase a fellow work colleague/runner recommended this guy I went to see him because I got to thinking my knee issues could be coming from my SI joint which had been sore for about 2 years, despite physio - and having had a major trantrum about a year ago.

That's background. Anyway this guy works with generally 3 visits. I've only had one yet, next is Friday. This last time he stood me in front of a mirror, told me one shoulder was higher than the other (which I couldn't see) asked me to turn my head in both directions and showed me I had more movement one way than the other. Then he laid me down. Held my ankles and pulled on my legs and lifted them off the bed about 6-12 inches and showed me how my ankles didn't line up. He then put one of his hands on each of my hips and pushed them down on the bed. Told me to lift one leg, then the other - I could feel one was easier than the other. He then got me to bend my legs so my feet were still on the bed but knees bent about 45 degrees and feet about shoulder width apart. He then got my knees and told me to push them together while he resisted with his hands. There was a big crack which he said was my pubic symphysis realigning. He then did the reverse of that so I pushed his hands apart. Then retested my leg length and they were even.

Then he cracked my upper back and twisted it around first one way and then the other. That was basically it. My neck also now turns a lot better (I might add I had a neck problem last year as well!).

He's showed my how to do the first bit myself. You do it from a sitting position on a chair, feel flat on the floor. Use your forearm so you have one hand against one knee and your elbow against the other. Brace your wrist by grabbing it with your other hand and and push in with your knees against your arm. Reverse your arm/hands and repeat. And of course your partner can check your leg length any time.

Next week he will show me other exercises to do.

I'm quite happy, I can feel the difference especially when I"m eg digging in the garden, my back doesn't get sore like it used to. But I'm still banned from doing squats etc simply because my cartilage etc etc are all still not in good nick as it were. They will take weeks if not months to repair, I"m just hoping that if my bodys all lined up right and the pressures on my knees are all good and even then they will get better over time.

Hope this makes sense! These guys have a website - musmed.com. The guy I saw is actually a surgeon. But it may be a chiro or osteo would do the same thing. What I like about these guys is they teach you to self manage so you don't have to go back all the time.

Shane Upchurch
09-16-2007, 01:58 PM
Thanks Aileen for the info. A lot of what you described was done by my phys therapist on my last visit which at least makes me feel like there is some method to their madness. I'll give it another shot and see what happens....Crossfit is a part of my life and I would go crazy not being able to do it.

Aileen Reid
09-16-2007, 04:27 PM
Sounds like you're on the right track then, that's good! Lets hope both you and I can get back to doing all that we'd like!

Steven Bourdage
09-17-2007, 12:11 PM
I am a chiropractor with a bad back (insert laugh here)

No but seriously, I have had a herniated disc in the lower back for many years now. Occaisonally it flairs up but, with chiropractic care from colleagues, core strengthening, and a lot of stretching I have overcome my disc issue.

I highly recommend chiropractic care along with some physical therapy to re-balance your muscles and increase flexibility.

Corey Duvall
09-17-2007, 12:52 PM
I'm a current Chiropractic student in which Crossfit has given me an epiphany about the body. Much of what manual therapists (PT's, chiro's, osteo's) do is based in human movement and the balancing of it. Well, so is Crossfit when performed properly. Many back problems are caused by too much movement of the back, which is due to a lack of hip flexibility. Proper squat form has zero back movement, proper deadlift form has zero back movement, proper rowing technique (Matt) has zero back movement. The power comes from your hips, not your back. Your back should remain stiff as a lever and if it doesn't there can be traumatic effects. Funny thing about disc bulges, many of us have them and don't know it. Many people who have MRI's will show a disk problem without any actual symptoms. This is because the pain arises from inflammation due to tissue damage, and not the actual bulge. Many patients who recover from disc bulges do so because they learn the proper way to move to prevent further tissue damage, not because their bulge disappears. My suggestion to you is to find a Crossfit Affiliate who will hammer your form and technique. I plan on opening an affiliate as my rehab center for my private practice. I have been training a few people here at school and have seen great success focusing on getting the patients to squat with better form, deadlift with better form, do ANYTHING the way their bodies were designed to work. Any manual therapist who doesn't have you squat, in my humble opinion, isn't worth their weight in gold. Human movement should be improved, not avoided. When you have pain during an activity, limiting the activity does not solve the problem, it merely hides it. IMPROVE your activity and you will solve the problem.

PS. I had an ACL reconstruction about 9 years ago and arthroscopic knee cartilege removal 8 years ago. Before crossfit I was still active but had periodic outbursts of pain, and couldn't squat even close to parallel without discomfort. I can now do ten pistols on that leg pain free. What did I do?? Learned to squat properly and did it a lot.

Good luck.

Ben Moskowitz
09-17-2007, 01:46 PM
Press Ups for back pain! feels good.

go to danjohn.org
it's Get Up! vol. 1 issue 11.

Shane Upchurch
09-17-2007, 02:45 PM
Thanks for all the info and hope guys. I've been steadily improving on my form but this injury occured long before I started crossfit. I think the other day I did some front squats and may have gotten a little out of shape and that set it off again, because not long before that I performed some ohs and they went wonderfully and I had no back pain whatsoever. I know its my form thats agitating it and I plan on talking with my therapist and showing him my problem with flexibility once I reach parallel in my squat. Again thanks for all the info.

Corey Duvall
09-17-2007, 03:17 PM
Best way to improve flexibility is to stretch... but I really hate sittin around for 15-20 minutes tryin to stretch a bunch of different muscles. Instead what I do is stretch the movements. Having a problem with squat flexibility? Then squat, unweighted of course. Get your feet shoulder width apart and squat down, weight on your heels. Squat all the way down: Now, push your knees so the align with your feet and get your chest in the air. Push push push into that position. You'll feel a stretch in your hips... you'll feel a stretch in your groin. Stay down there, 20-30 seconds at a time. Do it frequently, 3-25 times a day... as many as it takes.

On a side note, sometimes injury can result in scar tissue formation in the musculature. Not a terrible problem, but talk to your PT about some fascial (connective tissue) release methods. If this is the case, a few commercial names are Graston (graston.com) and Active Release (activerelease.com) in which you can find some practitioners. But really, any good manual therapist who performs myofascial release would probably help you improve your ROM

Shane Upchurch
09-23-2007, 12:28 PM
Had my first session with my PT this past friday. It went as expected, he told me some things I didn't want to hear like stop doing full situps, dont go below parallel in the squat, etc. I plan to do what he says until things get better then I will talk to him about going back to the crossfit way and see what he says. The exercises he gave me are already helping, as my back is feeling much better. He gave me mostly core strength stuff and said it doesnt sound like I am working my stomach enough. So far so good, we'll see how the snatch treats me today.

Corey Duvall
09-23-2007, 12:49 PM
True core strength is the resistance of motion, not the creation of it. The function of the core is to protect the spine from excessive motion and transfer power from the lower to upper extremity and vice versa. These are both best accomplished by resisting motion and making the trunk a static lever. However, it must remain so while in the most anatomically safe position, with a lumbar curvature. I think you have the right idea in following the advice of your PT (you ARE paying him), but some of the concepts of the body's abilities through Crossfit (core strength, full ROM exercise like squats and dips) are believed by the medical community to be unsafe. It is my belief, and the belief of crossfit, that these dangers are unfounded and are based on poor understanding of human abilities. Babies squat safely through a full range of motion, adults have merely lost that ability, and without proper rehabilitation of strength, flexibility, and motor control, attempting full ROM squats IS dangerous, but merely because they are done incorrectly. Bring up some of these ideas to your PT as your pain decreases and abilities improve.

Good luck.

George Mounce
09-23-2007, 01:41 PM
Cory hit the nail on the head. Core strength in CrossFit is stabilization of the mid-line (i.e. keeping a stiff mid-line during the OHS). PVC or Broomstick squats will do more for core strength without added weight IMHO then typical "core routines" which more often then not rely on a big inflatable ball.

I would ask what his definition of "parallel in the squat" is as the hip crease has to be at least even with the knee to be in a parallel state. If he's telling you to stay higher then that you could hurt your knees.

Hope you get well soon!

Adam Glenos
11-11-2007, 12:19 PM
Press Ups for back pain! feels good.

go to danjohn.org
it's Get Up! vol. 1 issue 11.

I must second this. I normally get lower back pain the day after doing either heavy lifts (deadlifts, squats, goodmornings), OR more dynamic motions involving the hips (cleans, snatches, sumo deadlift high pulls). If the weight is not heavy, the same goes for high reps - notorious in my crossfit experience thusfar. It normally lasts 2 days.

I can describe the pain as more of a tightness or stiffness. In addition, i can tell it is not a muscular issue. I feels closer to my spine, and is not a 'pain' per se, but more of a tight and stiff discomfort that surfaces only when i move.

That being said, press-ups have not only been the only thing that have helped, but they have helped immediately. In the article, Spiller describes the issue as an uneven stretching of the ligaments that hold your lower discs in place. The press-up aims to correct this.

Here is a direct link to the article (wfs) - see page 2
http://danjohn.org/gu11.pdf

Thank you Ben for posting this.