Lower Back Rehab

[James Besenyei]

For about 5 months my lower back was extremely stiff throughout the day and I had moderate to severe muscle spasms every few days. I finally bit the bullet and went to see a DO who specializes in sports medicine and spinal injuries. He believes that my problem is due to a muscle imbalance and my right glute and hip flexor not firing correctly. He seems like a very well informed doc and I generally like his advice so far: keep moving and work on fixing the muscle imbalance. I've seen him twice, the last time I visited he gave me a series of rehab exercises.

He prescribed these exercises: bird dogs; hip thrusts--bilateral & unilateral; split squats; and side bridges. I've only been on the routine for two weeks and I feel great immediately after performing the protocol. But, a few hours later I'm back where I started. Does anyone have any exercises, stretches, or other advice they believe may enhance the doc's protocol? Has anyone gone through a similar injury? If so, any pointers? Thanks in advance.

[Megan Zetter]

Originally Posted by James Besenyei

For about 5 months my lower back was extremely stiff throughout the day and I had moderate to severe muscle spasms every few days. I finally bit the bullet and went to see a DO who specializes in sports medicine and spinal injuries. He believes that my problem is due to a muscle imbalance and my right glute and hip flexor not firing correctly. He seems like a very well informed doc and I generally like his advice so far: keep moving and work on fixing the muscle imbalance. I've seen him twice, the last time I visited he gave me a series of rehab exercises.

He prescribed these exercises: bird dogs; hip thrusts--bilateral & unilateral; split squats; and side bridges. I've only been on the routine for two weeks and I feel great immediately after performing the protocol. But, a few hours later I'm back where I started. Does anyone have any exercises, stretches, or other advice they believe may enhance the doc's protocol? Has anyone gone through a similar injury? If so, any pointers? Thanks in advance.

Give it some more time.

What do you do for work? In addition to muscle imbalance, poor posture is often related to chronic low back pain.

[Brian Strump]

Agreed. From your post it sounds like you found a pretty knowledgable doctor to get you headed in the right direction.

You may want to ask him about working on some of the soft tissue of those areas too. Ask him about, <gasp> seeing a chiropractor for adjustments to help with mobility issues as well. We have had patients in the past that come to us, and the physical therapist.

[Anthony Ricci]

Agree with Brian and add that radiographs are a good idea to get a picture of the spine. Although it is limited to 2D snap shot -you can rule out anomalies and structural problems that cause the muscular imbalances and compensations.

[Steven Low]

Another looks good from here.

Since we haven't seen you ourselves it wouldn't really be wise to add anything to your currect exercise regimen either in this case. But I'm sure there is some mobility stuff you can likely do if you wanted to look into it

[Megan Zetter]

Originally Posted by Anthony Ricci

Agree with Brian and add that radiographs are a good idea to get a picture of the spine. Although it is limited to 2D snap shot -you can rule out anomalies and structural problems that cause the muscular imbalances and compensations.

Radiographs can show all sorts of anomalies that have been present for years and are asymptomatic and are NOT the pain generator or the problem. Therefore, radiographs typically are not warranted for mild musculoskeletal complaints. Too many doctors want to give the patient concrete evidence of why they are suffering. We have become too dependent on the concrete. MRI, x-ray, drugs, blood work, etc, are all fantastic tools and have their place, but they are not the answer to everything. It sounds as though the OP has a fine doctor and time is what is lacking at this point. Perhaps, as mentioned by Brian, co-treatment with a chiropractor may be helpful.

[Mike Laroche]

Originally Posted by James Besenyei

For about 5 months my lower back was extremely stiff throughout the day and I had moderate to severe muscle spasms every few days. I finally bit the bullet and went to see a DO who specializes in sports medicine and spinal injuries. He believes that my problem is due to a muscle imbalance and my right glute and hip flexor not firing correctly. He seems like a very well informed doc and I generally like his advice so far: keep moving and work on fixing the muscle imbalance. I've seen him twice, the last time I visited he gave me a series of rehab exercises.

He prescribed these exercises: bird dogs; hip thrusts--bilateral & unilateral; split squats; and side bridges. I've only been on the routine for two weeks and I feel great immediately after performing the protocol. But, a few hours later I'm back where I started. Does anyone have any exercises, stretches, or other advice they believe may enhance the doc's protocol? Has anyone gone through a similar injury? If so, any pointers? Thanks in advance.

I have been through (and continue to fight with) similar injury. It sounds like you are likely doing the right stuff. Steve Low has a great page on eatmoveimprove.com you should check out, its the article on shoes and lower body dysfunction. There are several links to great articles, check out all of them. The main thing that has helped me is hip thrusts.
http://www.t-nation.com/free_online_...the_glute_myth NOT WFS

Once you re-teach the glute to fire, start amping them up. I have been doing this protocol for probably 2 months or so now, and I am doing hip thrusts with 225 lbs for sets of 10-12. It has been the best thing to get awesome glutes. They protect your back.

[Anthony Ricci]

As a Chiropractor I like to have all the facts in front of me. things like Spondylolisthesis , DDD, and spina bifida change the rehab Rx so i am a little conservative-don't like to guess at someones health. ( I was one of those that was Rx the wrong exercises -Knife Clasp deformity and was injured ) but i understand trying to correct imbalances. Good Docs look at all the facts so they don't miss anything.
My 2 cents

[Megan Zetter]

Originally Posted by Anthony Ricci

As a Chiropractor I like to have all the facts in front of me. things like Spondylolisthesis , DDD, and spina bifida change the rehab Rx so i am a little conservative-don't like to guess at someones health. ( I was one of those that was Rx the wrong exercises -Knife Clasp deformity and was injured ) but i understand trying to correct imbalances. Good Docs look at all the facts so they don't miss anything.
My 2 cents

I see your point. I'm a chiro student actually, yet, we have been taught to NOT take x-rays unless you have a good reason -- the less radiation the better. Plus, with the stated changes/anomalies, treatment is not altered all that much. At least from my student understanding. You have real world experience though.

[Brian Strump]

Megan,

Ask the teacher what they'll say when it's their license on the line, not yours. We don't x-ray 100% of our patients, but most we do. Boarding an airplane will give you 100x more radiation than a few x-rays in a doctors office.

Especially if they are not improving we'll x-ray them to cover our ***. In a time when people can sue McDonalds for making them fat; I don't want to be added to that list.