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-   -   PT says no more Squats (https://board.crossfit.com/showthread.php?t=22805)

Shane Upchurch 10-22-2007 08:24 AM

PT says no more Squats
 
Ive been going to the PT for about 2 months now, again, for pain in my lower back. He has made it somewhat better but cannot seem to make it completely go away. The past two weeks I have not done any squats or dl's with weight, air squats only. Today he told me he didnt think there was much else we could do and that I may consider going to see a back specialists. He also said that I should leave out any type of squats for a while, weight or no weight, and see how my back feels, because it seems to flare up whenever I go into a deep squat. I was wondering if anyone else out there has experienced something like this? Im guessing I should do what he says but would like to know what you all think as well. He believes I may have a herniated disk that is touching a nerve. Its not that bad of pain just irritating more than anything, but I want to get it back to 100% so I can start doing some oly lifts. Any suggestions?

Jay Cohen 10-22-2007 08:53 AM

Re: PT says no more Squats
 
[QUOTE=Shane Upchurch;206994]Ive been going to the PT for about 2 months now, again, for pain in my lower back. He has made it somewhat better but cannot seem to make it completely go away. The past two weeks I have not done any squats or dl's with weight, air squats only. Today he told me he didnt think there was much else we could do and that I may consider going to see a back specialists. He also said that I should leave out any type of squats for a while, weight or no weight, and see how my back feels, because it seems to flare up whenever I go into a deep squat. I was wondering if anyone else out there has experienced something like this? Im guessing I should do what he says but would like to know what you all think as well. He believes I may have a herniated disk that is touching a nerve. Its not that bad of pain just irritating more than anything, but I want to get it back to 100% so I can start doing some oly lifts. Any suggestions?[/QUOTE]

Pending budget, my choices, not in order of importance:

MRI
Deep Tissue Massage
Second opinion from a PT that works with Athletes
Good OrthoPod that works with Athletes
Yoga

Keith Stevens 10-22-2007 08:54 AM

Re: PT says no more Squats
 
Are you having any radiating symptoms? What makes the pain worse or better? Whan happened when the pain started? Have you seen anyone beside the PT for treatment?
What has worked in physical therapy(ice, heat, stim exercise)?
What hasn't worked?
Have you had any X-rays or MRI taken?

Garrett Smith 10-22-2007 09:08 AM

Re: PT says no more Squats
 
The other advice has been good so far, my main addition is this.

Get with a really good CF trainer and make sure ALL of your squats are done with correct form, whether with a weight or without. There will be a pain-free ROM for your squat, however deep/shallow it is at this point, [B]stay within that pain-free range.[/B] Expand that range as your pain decreases. Inducing pain will only set you back.

Realize that you have a long time of CFing and OLing ahead of you and seriously work on this issue now.

Too many PTs (and even more doctors) wouldn't know good squatting form at all, so beware of squatting advice from that group in general.

Best of luck. Don't mess around with this issue.

Tim Donahey 10-22-2007 09:24 AM

Re: PT says no more Squats
 
Is your butt "winking" at the bottom of your squats? If it is your squat that is contributing to your back pain, it is probably an issue of tight hamstrings causing lumbar spine flexion. Try stretching your hamstrings before squatting and after exercise and only going as low as you can without the "butt wink."

Here's another thread on the topic (wfs): [url]http://board.crossfit.com/showthread.php?t=7113&page=1[/url]

Shane Upchurch 10-22-2007 03:37 PM

Re: PT says no more Squats
 
Okay, I have had x-rays that a dr. and pt have looked at, but the dr. was a urgent care dr, which I have been told are not always the best doctors. He saw nothing wrong nor did my PT. My PT did point out one joint just above the sacrum I think its called and showed me how the distance between the vert. were different but said he didnt think that was a huge problem.
I have quit doing weighted squats the past two weeks and that seems to have helped with the pain, but I can still feel it when I let my back hunch over at the shoulders and lean forward. The pain started 1.5 years ago and I dont know what exactly triggered it, most likely bad form in a DL or SQ (this was before I started CF). I havent seen anyone other than two different PT's from the same practice. It always feels good when I leave the PT but usually creeps back throughout the day. I almost always feel it, in my back and some in my right buttocks, when I sit down no matter what my posture is. I've trained some recently with CCT Joey and he hasnt seen anything awful in my squat but my form has changed dramatically since I started CF. Im not sure about the butt winking but I do hamstring stretches before every WOD.
Okay, I think that answers about everything...thanks for the advice guys and keep it coming.

Aileen Reid 10-22-2007 04:15 PM

Re: PT says no more Squats
 
I had back pain the last 2 years - actually sacroiliac joint pain. I had got to the stage where I couldn't squat because my back hurt too much. I ended up going to see a guy who told me my pelvis was twisted, my left leg was functionally 3 cm shorter. I did 3 visits to him and he manipulated my pelvis and give me exercises to do and no no more back pain. Indeed the knee pain I also had is markedly reduced as well!

Gant Grimes 10-22-2007 04:59 PM

Re: PT says no more Squats
 
[QUOTE=Aileen Reid;207183]I had back pain the last 2 years - actually sacroiliac joint pain. I had got to the stage where I couldn't squat because my back hurt too much. I ended up going to see a guy who told me my pelvis was twisted, my left leg was functionally 3 cm shorter. I did 3 visits to him and he manipulated my pelvis and give me exercises to do and no no more back pain. Indeed the knee pain I also had is markedly reduced as well![/QUOTE]

Sounds like SI joint. That's what did it for me. I'd see what a chiro had to say before going to another doc. You might be surprised.

Aileen Reid 10-22-2007 07:32 PM

Re: PT says no more Squats
 
Incidentally I was going to a physio for my back pain on and off over that 2 years, and having heaps of pilates. As you say, it helped but didn't fix it.

Shane Upchurch 10-23-2007 05:42 AM

Re: PT says no more Squats
 
Aileen what kind of doctor did you see?

Keith Stevens 10-23-2007 02:14 PM

Re: PT says no more Squats
 
It seems like a chiropractor will be a good fit for you, as long as he/she is NOT a rack and crack style of chiropractor. Someone experienced with athletic injuries, muscle work and analysis, postural correction and cold laser therapy. If you want some recommendations, or have questions about a certain DC, let me know. Good Luck!

Shane Upchurch 10-23-2007 02:36 PM

Re: PT says no more Squats
 
How would I identify a chiro that is not a "rack and crack" style of chiro? If you have any recommendations for any in the Charlotte, NC area I would definately like to know...I will be moving there shortly.

Tim Donahey 10-23-2007 05:14 PM

Re: PT says no more Squats
 
[QUOTE=Shane Upchurch;207553]How would I identify a chiro that is not a "rack and crack" style of chiro? If you have any recommendations for any in the Charlotte, NC area I would definately like to know...I will be moving there shortly.[/QUOTE]

Their fee is a good indicator (mine charges $25 per session), also if they offer massage, trigger point therapy, and other "alternative" treatments.

Matt DeMinico 10-23-2007 05:36 PM

Re: PT says no more Squats
 
[QUOTE=Shane Upchurch;206994]Ive been going to the PT for about 2 months now, again, for pain in my lower back. He has made it somewhat better but cannot seem to make it completely go away. The past two weeks I have not done any squats or dl's with weight, air squats only. Today he told me he didnt think there was much else we could do and that I may consider going to see a back specialists. He also said that I should leave out any type of squats for a while, weight or no weight, and see how my back feels, because it seems to flare up whenever I go into a deep squat. I was wondering if anyone else out there has experienced something like this? Im guessing I should do what he says but would like to know what you all think as well. He believes I may have a herniated disk that is touching a nerve. Its not that bad of pain just irritating more than anything, but I want to get it back to 100% so I can start doing some oly lifts. Any suggestions?[/QUOTE]

Does it feel like muscle soreness? I've had it twice, the first time I laid off all back type exercises (deadlifts, rowing, most squats, stretching it, etc) and it stopped, I never found out the source. The second time I finally realized it started when I was rowing, because I was bending my lower back on the catch. I fixed that problem and it's getting better right now.

Aileen Reid 10-23-2007 11:50 PM

Re: PT says no more Squats
 
My guy belongs to a group with a website called musmed.com (w/f safe). They are interdisciplinary. Not sure if you have an equivalent in the states. He generally does 3 visits only and at the end of that you're self sufficient in techniques to keep you right.

Corey Duvall 10-24-2007 07:41 AM

Re: PT says no more Squats
 
That seems like a great group. Do they have chiropractors associated with it? I just might have to move to australia after graduation, haha.

In all honesty... look for a chiro who considers themselves musculoskeletal specialists. Certainly, there are lots of good chiropractors out there but some of them often focus solely on the joints of the spine and ignore, or do a mediocre job at best in dealing with the soft tissues and extremities. Find one who looks at the whole body, will probably utilize functional tests to see how well you move, and will treat what doesn't move properly, not just what hurts. Chiro's with a spinal focus do a lot of good for folks, but often there is more to the body's dysfunction than solely the spine. Good luck.

Keith Stevens 10-24-2007 08:08 AM

Re: PT says no more Squats
 
Corey hit the nail on the head! You can usually determine if they are a rack and crack or not buy asking questions about what a typical visit includes, if the do muscle work, address postural changes(and ergonomics), and work on/adjust extremities. Typically a DC who does this is looking at the body as a whole and trying to find the cause as opposed to taking care of pain locally.
I have a collegue on the border of NC and GA but he nows several in the Charlotte area. I'll post the names ASAP. When are you heading that way?

Kelly Brown 10-24-2007 11:50 AM

Re: PT says no more Squats
 
[QUOTE=Shane Upchurch;207165]Okay, I have had x-rays that a dr. and pt have looked at, but the dr. was a urgent care dr, which I have been told are not always the best doctors. He saw nothing wrong nor did my PT. My PT did point out one joint just above the sacrum I think its called and showed me how the distance between the vert. were different but said he didnt think that was a huge problem.
I have quit doing weighted squats the past two weeks and that seems to have helped with the pain, but I can still feel it when I let my back hunch over at the shoulders and lean forward. The pain started 1.5 years ago and I dont know what exactly triggered it, most likely bad form in a DL or SQ (this was before I started CF). I havent seen anyone other than two different PT's from the same practice. It always feels good when I leave the PT but usually creeps back throughout the day. I almost always feel it, in my back and some in my right buttocks, when I sit down no matter what my posture is. I've trained some recently with CCT Joey and he hasnt seen anything awful in my squat but my form has changed dramatically since I started CF. Im not sure about the butt winking but I do hamstring stretches before every WOD.
Okay, I think that answers about everything...thanks for the advice guys and keep it coming.[/QUOTE]
My 2 cents. Okay, maybe 2 1/2.

Sounds like a lumbopelvic mobility/stability problem to me. As a PT I can tell you that there is a lot of misinformation about squatting in our community. I do agree that [B]if it hurts you shouldnt do it[/B]. I would guess that some stretching and more active abs with your squats should improve the situation.
I cannot truthfully say that I am not biased, but please be careful with chiropractors. Especially if they recommend prolonged treatment. If your x-rays are fine then the problem is most likely soft tissue and the only way to permanently correct soft tissue problems is to restore the muscle balance. In my opinion, exercise, the right exercise, is key.
Someone in here mentioned pilates. Pilates is great for helping you find your core and learn how to control it but the exercises dont really translate to function. You have to use the awareness of those muscles you can get from pilates and apply it to functional movement.

Some PTs are planning to get together at the Affiliate gathering to talk about PT concepts and Crossfit and how we can increase awareness in both communities... stay tuned:)

Aileen Reid 10-24-2007 05:23 PM

Re: PT says no more Squats
 
That's what I like about this guy - 3 visits each 2 weeks apart. Each visit he teaches you something else to do for yourself - as well as looking at you, adjusting you etc. I think what he does is a lot of chiro type stuff. I'm now staying "in" most of the time after my 3 visits. Just doing my exercises most days and my own "adjustment" several times a day as much as a check as anything else but being on leave at the moment and doing a lot of heavy work and often one sided stuff - bending, digging, demolishing bathrooms......, I feel its really being put to the test.

Over time I am now able to go heavier on eg squats and leg presses. Deadlifts are my most difficult one still, I guess after 2 years of being "out" it will take time for all my soft tissue to strengthen, lengthen, shorten, whatever and get back to normal. So I am loading up gently. All my butt pain is gone and I can dig in the garden all day and not feel crippled at the end of it!

Blair Robert Lowe 10-25-2007 01:04 AM

Re: PT says no more Squats
 
The Chiropractor I had started going to, is the one our head coach picked up locally from the ones he tried out. He was looking for a good chiro to refer our gym kids to. His opinion is that if they're body is out of alignment, gymnastics will be tougher simply put, not even going to the impacts of it.

He was pretty interesting and was able to find interesting points on my body that were all tense due to muscular imbalances, some of these being caused by skeletal injuries.

I was really interested in finding out what was all messed up. Mostly it's due to some muscles just being far too tight, pulling things out of alignment.

I'm hoping to go back when I can find the time and money. It's been crazy since August. Even the idea of being fully functional in my shoulders makes me dream of pain free gymnastics.

Corey Duvall 10-25-2007 02:38 PM

Re: PT says no more Squats
 
[QUOTE=Kelly Brown;207916] but please be careful with chiropractors. Especially if they recommend prolonged treatment. [/QUOTE]

I must agree here. It doesn't take three visits a week for six weeks to fix any of your problems. I am only an intern, and have not seen any severe cases, but if I've worked on the right areas, improvement is seen after that first visit by way of functional tests, and often in 3-4 visits I can be 90% complete with my part of the case. Proper compliance by the patient with the exercises and stretches I prescribe and we're good to go. If the chiro speaks to you of the "danger of subluxation" or anything similar, find someone else.

Shane Upchurch 10-25-2007 08:34 PM

Re: PT says no more Squats
 
Sorry, I was out of town for a while and so I havent been able to check the post. Thanks for all the info. I'm researching chiro's in the Louisville area now, though I will probably be moving to the charlotte area within a month or so. I'll keep you all updated on progress...I wont know what to do without back pain after 2 years of it.

Aileen Reid 10-26-2007 05:07 PM

Re: PT says no more Squats
 
Well after getting rid of mine after two years I can tell you, you adjust! Its wonderful, I no longer feel like the clocks ticking and its all downhill! :-)

Karin Jonczak 10-26-2007 05:21 PM

Re: PT says no more Squats
 
Add to what Jay said, I would go see a really good Rolfer as well. No matter how you feel about chiro, I hold the belief that if you don't get the muscles in alignment as well the chiro 'fixes' aren't going to help.

And get a good coach too... maybe you do something really subtle in your squats that you need to change.

Karin

Jim Devlin 10-27-2007 06:21 PM

Re: PT says no more Squats
 
[QUOTE=Kelly Brown;207916]My 2 cents. Okay, maybe 2 1/2.

.... As a PT I can tell you that there is a lot of misinformation about squatting in our community. [/QUOTE]

Kelly,
Thanks for giving us your point of view. The December 2002 had an article on air squats "Dec 2002 - Squat Clinic". Do you have any concerns about the suggestions given in that article?
Jim

Rob Marrison 11-02-2007 10:36 AM

Re: PT says no more Squats
 
Hi all, I too have a disk problem - been out of all weighted and flexion training for 9 months now. Which sucks.

I've been following back pain threads looking for answers for a while and thought i'd put in my own 2 cents.

I haven't heard "MacKenzie Method" or Robin MacKenzie mentioned on any of the threads so far, but I so far I swear by it. I've been to two PTs so far. The first thought it was joint issues and manipulated be with mixed results - sometimes pain. The second is into MacKenzie, which seems to be working.

Watered down, the theory is that we put our spine in flexion too often and this stretches the ligaments that hold in the **** at the same time as compressing the disk on its forward edge. MacKenzie recommends regular back bends to put one's spine in extreme extention in combination with never placing one's spine in flexion untill the disk has healed. At which time you can slowly and gently move into flexion and work through the scar tissue.

My PT gave me a lumbar roll to use at all times when sitting. Between that and the back bends my pain very quickly left my heel and traveled back up my leg, into my spine and then disappeared. Now so long as I watch my posture I'm pain free.

We are now working on getting me back into flexion and compression exercises slowly and carefully. Its been a long and depressing ride, but I've learned a lot. The next step is to develop apsolutely perfect form for squats and deadlift. No more butt winks etc.

I think people who are into Crossfit need to ask themselves if competition and personal bests are so important as to allow less than perfect technique. I have seen lots of problems in the videos and I know that on a long enough time line that will equate with unnecessary injury.

Anyway, consider reading Robin MacKenzie's "Treat Your Own Back," purported to work for 80% of back pain sufferers - works for me - and much cheaper than PT,s, Chiro's, etc.

Steve Baum 11-02-2007 03:48 PM

Re: PT says no more Squats
 
I would suggest finding a Level II or higher CHEK Practitioner to assess your lumbar curve and muscle length/tension relationships. If you have too much or too little pelvic tilt with no external resistance it will only be magnified when you add weight and perform dynamic movement patterns. They could also help identify isolated muscle weaknesses that are contributing to postural distortions. Once the imbalances are identified a good corrective exercise program should solve the problem. You may have to descend the squat pattern for a while before progressing back to regular squats. Another possibility is digestive dysfunction. If you have any digestive issues or food intolerance issues your "core" muscles may not be functioning properly. This is fairly common. Irritation in the gut shuts down the muscles and leaves you with spinal instability.
Look me up if you come through St. Louis and I'll help. I can also help you find someone in your area if you are interested.

Steve

Kelly Brown 11-02-2007 08:20 PM

Re: PT says no more Squats
 
[QUOTE=Rob Marrison;211061]I haven't heard "MacKenzie Method" or Robin MacKenzie mentioned on any of the threads so far, but I so far I swear by it. I've been to two PTs so far. The first thought it was joint issues and manipulated be with mixed results - sometimes pain. The second is into MacKenzie, which seems to be working.[/QUOTE]

Okay... I have offer a word of caution here. The MacKenzie method can be very effective in treating [I]some[/I] back injuries, but in some cases it is the opposite of what is needed. MacKenzie, like many great innovators in our field, sends a message that these techniques can work for anyone. It really depends on what the pathology is (i.e. disc, facet, soft tissue) I am seriously not trying to just plug my profession, but I think it is very dangerous to prescribe rehabiliative exercises without first knowing what the problem is. For example, if a person has spondylolysthesis, aggressive extension could make the problem significantly worse, like neurological damage kind of worse. So I am going to go ahead and put in 4 cents on this one. If you have had an injury and found a technique that works for you, great! Share, so others can ask their health professional about it. But if you have a back injury (or any injury for that matter) that has not been evaluated and diagnosed by a trained medical professional, [I]please[/I] do not try to self-treat. The possible consequences are not worth the savings in cash. Enough said.

Kelly Brown 11-02-2007 08:22 PM

Re: PT says no more Squats
 
[QUOTE=Jim Devlin;209109]Kelly,
Thanks for giving us your point of view. The December 2002 had an article on air squats "Dec 2002 - Squat Clinic". Do you have any concerns about the suggestions given in that article?
Jim[/QUOTE]

I have not read this yet, but I will and get back to you.

Kelly Brown 11-02-2007 08:41 PM

Re: PT says no more Squats
 
Okay.. I just re-read the Squat Clinic article.
No, I dont have any problems with it. In fact, I think its pretty spot-on. Its one of the concepts that brought me over the fence from rehab mindset into the Crossfit world. There is a little inconsistency in the chart on the last page regarding faults and remedies with the adductor/abductor explanation, but the error is in the language not the concept. Thanks for asking :)

Jim Devlin 11-02-2007 09:51 PM

Re: PT says no more Squats
 
Kelly,
What about back squats. Some folks have suggested that the low-back position of the bar can be hard on the shoulder joints over time. Any thoughts?
Jim

Kelly Brown 11-04-2007 02:35 PM

Re: PT says no more Squats
 
Jim

I guess if you were doing a lot of them. I am not a huge fan of back squats just because I dont think they are super functional for most of us. We put them into the mix every once in a while at our gym. If you were doing them 3x/week or something it might be rough on the rotator cuff over time. Other than that, I wouldnt sweat it.

Corey Duvall 11-05-2007 11:15 AM

Re: PT says no more Squats
 
[QUOTE=Jim Devlin;211258]Some folks have suggested that the low-back position of the bar can be hard on the shoulder joints over time. Any thoughts?
Jim[/QUOTE]

IMO, it would be hard on the joints if improper shoulder blade flexibility exists. If the shoulder blade cannot be pulled back far enough this will stress the rotator cuff abnormally and cause issues. It will show up in back squats, it will show up in throwing baseballs, it will show up in swimming, it will show up getting things off a high shelf. Proper flexibility allows for proper technique and execution.

Shane Upchurch 11-05-2007 01:02 PM

Re: PT says no more Squats
 
Nobody has mentioned this from this thread but...I found a pilates reformer machine for cheap on craigslist and I was thinking of buying it, but before I do I wanted to see what some of you thought about this idea? Do you think that this is something that could help rehab my back injury? Again, I have quit squatting, dl'ing, and most of the oly lifts and have been focusing on my rings etc., but due to other factors I cannot see a Dr. or chiro at this time and so any kind of rehab I can do on my own would be great. Has anyone tried anything like this for this specific reason? Any thoughts....?

David Wood 11-05-2007 01:33 PM

Re: PT says no more Squats
 
I wouldn't buy a Pilates reformer unless you know what you're doing with it. Pilates doesn't get much credit here on this board, but it can be great in certain populations, and, done right, it is NOT easy.

But very few folks will do it well without some serious instruction and/or discipline.

Doing gentle stretches, leg presses, etc. in an unfocused way on the reformer won't hurt you . . . but it's unlikely to do you a whole lot of good, either.

Shane Upchurch 11-05-2007 01:46 PM

Re: PT says no more Squats
 
Yea, it comes with an instructional video but other than that I would have no clue what I was doing. Guess, after 2 years, Im just grasping at straws for something to heal my back.

Shane Upchurch 11-05-2007 06:39 PM

Re: PT says no more Squats
 
Rob, what kind of exercises or stretches does your guy have you do? Is a lumbar roll like a foam roll?

Aileen Reid 11-06-2007 01:11 AM

Re: PT says no more Squats
 
Shane, if you do a search on my posts, in one of them I went into infinite detail on what my guy did to me. And it was that simple I reckon if you have a friend/partner that can lend a hand I would give it a go and see what happens.

Shane Upchurch 11-06-2007 10:42 AM

Re: PT says no more Squats
 
Aileen, I performed a search and came up with 116 threads...do you think you could narrow it up any? Do you remember is this post in injuries, fitness, etc....or a date maybe? Anything to narrow the search down.

Aileen Reid 11-06-2007 05:14 PM

Re: PT says no more Squats
 
Gosh have I been talking that much! :-) I'll have a look and get back to you.


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