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Injuries Chronic & Acute

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Old 10-09-2002, 05:48 AM   #1
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Whoo Hoo, I am so happy to be the guy to start this. Well, not really but I'll start anyway. I would like to try the Crossfit method but I've got a problem: my lower back. Yep, she's a fickle mistress sporting a couple herniated discs and a compression fracture. As you can see she keeps me in from the fun on occasion. Seriously, I am looking for ways to benefit from the Crossfit mehodologies while not making things any worse than they are. Namely, the big compressive and shear loads that the Olympic and Powerlifts generate are probably out for me. I have been trying to make due with substitute exercises like single leg squats, handstand pushups, dips and the like. How can I modify the workouts to suit my abilities?
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Old 10-09-2002, 11:42 AM   #2
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Hello Hakim. I am a trainer at CrossFit. I responded to a couple of posts on the old message board regarding this same scenario. I personally have seen many people with lower back pains miraculously "heal" through exercise such as rowing, back-extensions, dead-lifts, etc. This spans from athletes to "couch-potatoes". I too have a pretty messed up lower back: a ruptured L-5 (and a torn C-6). The torn C-6 was from grappling and the ruptured L-5 occurred about 4-5 years ago while helping a friend do a roofing job. Thus, I know full well the horrifying pain that is experienced when the lower back "goes out" and I know how it feels and what it is like not to be able to move, ...period. It's about the worst pain I think I have ever experienced. My lower back injury was what kept me out of Jiu-Jitsu for a long time.

Don't get discouraged about that lower back though. I have rehabilitated many lower backs during my time as a conditioning specialist, as well as my own. The truth is, by strengthening the musculature in the trunk as well as the entire glut/ham/spinal complex, as well as stretching, you can significantly reduce your chance of re-injuring your back again. Not only that, but overall it'll just "bug you" less. I still feel my lower-back every now and then, some days a little more than others, yet I am still able to do heavy squats, dead-lifts and power-cleans, 185 pound jump-squats, etc, etc. Just progress smoothly and intelligently, yet assertively, and you should overcome it given enough time. Sure, as I was rehabilitating my lower back, it did go out on me a few times and yes, I knew right away when it did. The horrible pain was a visceral clue. I luckily had a great chiropractor right across the parking lot of the gym who would adjust it back into place and I'd be good to go within an hour of my adjustment. I know that many have a contraindicated view of chiropractors, even some within the CrossFit camp, and I understand why, but I suppose I have "lucked out" for they have served me well with my injuries, especially my back and shoulder injuries. You may never be "100%", but you'll more than likely get close. Look at it like a long-term goal of rehabilitation. If I personally can go from not being able to walk for several days, doing weighted jump-squats with 185 pounds on a bar on my back for 40 reps, then you too should be able to overcome your injury, at least to a point where you are not in fear of it going out on you. I might seem a little long winded on this, but as I mentioned, I know what it's like to have blown out a disk *and* to have overcome it.

As far as working around your injury and still being able to do CrossFit, you'll just have to use your best judgement as far as progression and weights. Be extremely weary of any doctor who tells you you're doomed. You want to take an assertive and aggressive role in rehabbing your lower-back because lack of use is the worst thing you could do, but you want to be smart about it as well and keep your progression smooth. You should be able to find a good sports chiropractor/doctor/physical-therapist that would give you some guidance in an assertive rehabbing of your lower back. If you try three different "specialists" and have no luck, then check out a fourth or a fifth, etc. If the ROD calls for power-cleans at your body weight, well, it might be in your best interest to be a bit trepidatious until you are more confident in the strength of your lower back; thus use a lower weight, lower-reps, etc. If movements like power cleans seem out of the question right now, then start working consistently, maybe every day or every other day, on back-extensions. Then progress to dead-lifts (NOT stiff-leg dead-lifts). Using proper technique, back-extensions and dead-lifts work extremely well for strengthening the musculature of the lower back, and thus rehabbing the lower back. Don't always necessarily go to "failure" on the back-extensions. Just get in a few sets throughout the day even. Thus you will be getting in lots of *volume* on that movement.

In my personal rehabbing of my lower back, I was working back-extensions and the dead-lift (not stiff-legged dead-lift), and other leg movements such as walking lunges and air-squats, hard for months before I felt confident squatting heavy again. But my chiropractor assured me that I would be able to squat heavy again and sure enough, given enough time, I was able. As cliche and "new buzzword" as it may sound these days, developing exceptional "core-strength" is essential.

If there are several elements within the ROD's that you are unable to utilize at this time, then just modify as necessary. If you have been reading through our archived ROD's, our Foundations page, and the rest of our site, then you are probably developing some sense of what we are looking for when we train. ..."Pulling" motions, "Pushing" motions, opening the angle of the trunk/hip, closing the angle of the trunk/hip, etc. Thus, even though you may have to alter or substitute a movement here and there, you can still follow the basic principles of CrossFit and incorporate them into your training. You should still be able to do things like supersetting pull-ups with dips, sprinting on a bike, push-ups, Tabata-squats, lunges, etc.

Also, after an intense ROD or a tough workout, I would highly recommend that you ICE. You might not "feel" any aggravation in the lower back after training, but just from the utilization of it, it can still get a little inflamed if there is a pre-existing injury. Thus, ice after. Sure, it can be an inconvenience at times, but look at the big picture. When you get home late in the evening and you are sore and tired and want nothing more than to crawl into bed and sleep and thus are debating as to whether or not to ice because the ice pack is all the way down stairs in the freezer, just ask yourself how you want to feel in the morning. Out of all the high-tech gizmo's they have at the sports-med center at the US Olympic Training Center in Colorado for rehabilitating sports injuries, what they rely on the most is *ICE*. Stretch lightly before the ROD or modified workout and a little heavier at the end, and then *ICE*. It'll accelerate your overall recovery process.

One last thing; ...Sport yields many amazing stories of enduring through injury to persevere and conquer. Two of the most recent that come to mind are Kerri Strug who during the 1996 Olympic games suffered a severe ankle injury yet managed to fight through the injury and stick a perfect vault and landing while in extreme pain from the landing, ...and consequently secure the Overall Gold for her team, the first ever U.S. Team Gold Medal.

The most recent however occurred at the 2000 Sydney Olympic Games. A U.S. Olympic diver by the name of Laura Wilkinson while in preparation for the Olympics suffered a severe foot injury. She broke three bones in her foot during training in March of 2000, less than six months before the games. She was unable to dive for two months while recovering from her injury. During that time she was forced to rely on "mental imagery" of her dives as her only real training tool. She was only able to start diving again just weeks before the US Olympic Trials; thus her even qualifying for the Olympics was amazing in itself. She hadn't completely healed from her injury and needed surgery but chose to postpone it until after the Olympics. Thus, not being fully healed from her injury she was forced to wear a special booty to climb the ladder of the diving platform. She said that with the break in her foot it felt like walking on a sharp rock every time she took a step and that it was quite painful.

The injury was seen as a serious setback by most...yet she used it to her advantage. She didn't let it defeat her. She instead made it work for her. At the very beginning of the event, after the first round of dives, she was in last place...yet she came through and after the final dive in the final round of the event, she won the Gold medal in the Women's 10m Platform Dive!--The first time in 36 years that the U.S. had won that event!

Injuries can either break you down and destroy your will...or lift you up and hone your will. ...Just gotta persevere. When I ruptured the connective tissue in one of my hands and seperated the carpal bones in my other wrist and couldn't do upper body or any of the complex movemtns, I shifted my focus to trunk, legs and sprint work. Now athletically my legs are an asset rather than a "weakness".

Sorry for the long-winded spiel here, but there are many others out there who suffer from the same affliction. Lower-back pain/injury is a bane to many. ...As is true with any injury, but especially a lower-back injury, it is necessary for people not to throw in the towel and simply accept their fate. Overcoming it just takes work, persistence, discipline, etc.
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Old 10-09-2002, 07:32 PM   #3
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Thank you for the thoughtful and informative reply. I appreciate the time and effort that went into writing it. Now, I feel kind of bad for the smart aleck tone of my initial post. But I figure at the very least I should get some jokes out of this. Your thoughts were very informative and encouraging. I fully agree on the prescription for ice and stretching: they are superior to any medication I have tried and carry few in any consequences when used properly.
Something else I have learned along they way, especially as I get older: I feel very happy most times I work out--just being able to do it, going at it hard, and I appreciate it as one of life's gifts. So I'm always looking for some way--new or not so new--of getting a little faster, a little stronger, a little fitter. I'm no great athlete but I like the pursuit. Looking around for information was how I happened on your site.
I have tried to develop the core strength you mentioned but have not pursued this systematically and therefor have had only moderate success. As a result of not doing the big basic moves, my lower back is weak and I know this only exacerbates the existing problem. I will take your advice on back extensions. Do you have any advice on other beneficial exercises? I heard of glute/ham raises and they seemed like something worth trying. Finally, I don't live in yor neck of the woods but would like to work in a visit with you guys. Do you work with people on this basis and if so how do I arrange this? Once again, thanks for all your help.
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Old 10-10-2002, 10:08 AM   #4
Frank C Ollis
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Location: Vista  CA
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Just a suggestion, but give yoga a try. I have a friend who was seriously injured by shrapnel and a bad fall, and he was basically an invalid for years. He started Yoga and is now both flexible and relatively pain free. I have started him on the CrossFit path, primarily the gynastics, bodyweight stuff, and we have very little problem. My only qualifier is to suggest that you start very light, and use the supplemental movements first. To build a good base.
The fact that you are on this forum, and training at all, says alot about your character. Most people give up. We are here for moral support!
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Old 10-10-2002, 04:33 PM   #5
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No problem. Your welcome. As for the humor, you have nothing at all to be sorry for. Believe me, humor can take the edge off of a lot of things that life throws us. I'm sure many who read this board can appreciate some humor. I know I often laugh and make jokes at such things as my back.

Ice and stretching are great. Like I mentioned in my last post in this discussion, ice is used extensively at the U.S. Olympic Training Center in Colorado. They'll be the first to say so. People say they stretch and ice, but when I ask and question and pry further (a couple of my clients for example) I discover that most only do so sporadically or only when the pain is high. After an intense workout or utilization of the lower back through lots of back-extensions and dead-lifts, etc, you may wish to ice for 15 minutes afterwards or before you go to bed, regardless of whether or not you feel lots of pain. In an area of pre-existing injury such as both of our lower backs, through intense work the area can become a little inflamed regardless of pain or no pain. So while you are taking a pro-active role in rehabbing your lower back, you may wish to ice and stretch frequently. It's just part of the gig.

You might also explore Frank C. Ollis's suggestion regarding yoga if you can fit it into your schedule. I have known several who have gone this route once or twice a week and they thoroughly enjoy it and benefit from it. It has helped several that I know increase their flexibility, body control and awareness, breathing and to some extent, their strength. Part of it though is that most of us who really need to stretch, don't do so enough. How many do you know that will actually stretch for twenty minutes a day? ...Even while at the gym? So by actually attending a yoga class you are forced to go through the whole thing without interruption from phone/neighbors/kids/gym-buddies/whatever. Thus part of the benefit of taking a yoga class comes from simply *doing* it every week.

You may also wish to start taking some Omega-3 fatty acids, specifically, EPA marine lipids. There are many, many reasons to take these and so I won't go into too much depth here in this post. But one of the benefits is that they yield a much lower pro-inflammatory profile, thus even aiding in such things as arthritis. If you follow the paleo-realm at all such as Dr. Lauren Cordain's work, one of the aspects that they discuss is the Omega-6/Omega-3 (n-6/n-3) fatty acid ratio before the advent of the agricultural revolution compared to now. They estimate that before the domestication of grains, legumes and fatty animal meats/dairy, that the ratio of n-6 to n-3 was about 2:1, where as now it ranges between 10:1 and 25:1, depending on global location. A recent study from the UCLA school of medicine showed that breast cancer cells while in the presence of Omega-6 fatty acids were encouraged to grow/multiply, whereas when in the presence of a high Omega-3 fatty acids there was no growth at all. Current guidlines from the paleo realm are to strive for a ratio of about 2.1:1 of n-6 to n-3.

Furthermore, (check with your doctor about this of course--"disclaimer") but during times of much higher than usual discomfort, you could try 800 milligrams of Ibuprofen three times a day for up to three days, so long as you don't have any known allergy responses (some do) or contraindications with other medications (some will). That was the original clinical hospital dosage before the FDA approved it for over-the-counter sale. If you go to Europe or South America, Ibuprofen comes in 800 milligram pills with a dosage of one pill, not the 200m pills as in the States. But like I said, ...anytime anyone gives you "medical advice", you should run it by your family doctor before acting on it.

Frank is right when he says that you being on this forum and training at all is a definite show of your character. As Frank mentioned, many sadly just give up.

As far as other lower-back exercises to help you along your path, yes, the glute/ham raise is another great movement, much like a back extension though a little more intense and with a higher demand on the glute/hamstring complex. The two armed kettle-bell (or D.B.) swing may or may not be an option for you. Perhaps if you try it you may not wish to push the reps too far or the heavier weight too soon, and most certainly utilize great form. The Concept-II rower will also yield some benefit here, though it can't be considered a specific means of developing raw strength in your lower back compared to something like a back-extension. For sure the back-extensions and the dead-lifts if you are able. Again, not stiff legged dead-lifts. The sports chiropractor that I went to, while assuring me that I would most certainly be able to squat heavy and deep again, also highly advised me against doing the stiff-legged dead-lifts or the good-morning type movements as they have an affinity for squirting the contents of the intervertebral disk out and into the nerve, hence, lots and lots of pain. The stiff legged dead-lift and good-morning type movements are excellent movements for developing the hamstrings and are great for athletes, and so I would, against the docs advice, try them out here and there and would always feel more than usual "not-the-good-kind" pain in my lower back the next day, despite using exceptional form. I can do them with a light weight though without much problem, but for the most part, that is the one and only movement that I have kind of passed on as far as working it with any kind of serious intensity. But look at it this way, though having a ruptured disk, through rehabbing my lower back, that is now the only movement that I can't really utilize with too much intensity. Not bad at all compared to where I started when the injury occurred. It will take you time/effort/dedication/consistency to rehab your injury, but what do you have to lose by doing so? :-)

As far as getting in to see us at our CrossFit facility for a few sessions, where do you live? We have had several athletes from different areas, as far as Sacramento, San Francisco and farther areas of California drive here for a training session. Some do so once a week, others once a month. We have had several people e-mail us regarding flying out here from different parts of the nation, including New York and Florida. We have even had athletes commute an hour a day (one-way) several times a week to train with us. It all depends. We try to accommodate all who are interested if we are able to do so. Sometimes we'll have an athlete come up from southern Cal and either stay with a friend/family-member they know in the area or get a room somewhere. Either myself, Greg or Lauren would love to help you out should have the desire to make the trip. Regardless of who you choose to work with while here, I think it would be great for you to meet all of us here at CrossFit when you are here. If you chose to work with me personally I would be more than willing to do so, but would still love for you to meet Greg and Lauren (owners and founders of CrossFit) while you are here. Greg is certainly the driving force behind CrossFit. Put simply, without him, CrossFit wouldn't have existed. You can e-mail one of us directly to set it up if you like. Our e-mail addresses are as follows:
Greg ("Coach"):
Me (Jason) ["J-Dog"/"Vindico"]:

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Old 10-12-2002, 11:30 AM   #6
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Jason and Frank:
Some great information here. I have done Yoga and experienced substantial benefits. Many of the stretches prescribed in the current spinal stabilization programs used by physical therapists are really Yoga poses. My experience with Yoga has been that you have to be somewhat selective because some of the poses are definite back and joint thrashers. Also, Yoga seems a little tradition bound and not particularly effective for developing strength and endurance.
One form of Yoga, the swaropa(sp?)series, is targeted at releasing the sacral muscles and the hip musculature. The series is a fairly easy to learn and practice and appropriate for most people. As you know, inflexible and tight hamstrings and hips=back pain and mediocre performance. The flexibility you obtain also brings with it an added benefit of relaxation and a feeling of control over your body. I believe this is very beneficial because it helps prevent the most debilitating aspect of any injury: feeling at the mercy of something you can't control and, worst of all, feeling sorry for yourself. I guarantee that will never make anything any better.
Lately, I have incorporated physical therapy/yoga stretching into gym-based workouts to make sure I do it regularly. One thing that is interesting: the benefit from stretching seems to be short-lived--several hours usually. I wonder how this could be lengthened?
Here's something interesting to think about. A doctor at UCSF told me the results of a recent study. Subjects with low back pain who demonstrated the greatest degree of improvement engaged in aerobic activity in excess of 40 minutes at 75% or greater of maximum heart rate for four times a week. I do not know what other activity they did beyond this nor what the specific aerobic activity was. However, they probably achieved several things: kept their weight down; received a good endorphine dose; strengthened their transversus abdominis and thereby achieved a better stabilized spine more resistant to injury. This is supposition but that is a fairly high level of activity and probably means the participants were athletically accomplished and, if that is the case, they probably demonstrate good movement patterns emmanating from a stable trunk. If all this is true, then this is one more reason to train the core for strength and proper sequence of movement, originating from the core then to the limbs. Spinal stabilization programs also emphasize developing a strong core with a properly aligned spine and maintaining this.
I'm from out of town--Reno--and am trying to figure out how to schedule a trip so I can come visit you guys and get in some training and observation. I'll be in touch but it may be a little while; I'm getting married soon--she's getting the ring tonight! Well, have a good weekend guys and I hope to hear from you soon.

PS: I'm not giving up until AFTER I'm dead.
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Old 10-12-2002, 02:45 PM   #7
Departed Derek is offline
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Best medical advice I ever got or gave!}
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Old 01-06-2003, 11:37 AM   #8
David Cooke, Jr.
Member David Cooke, Jr. is offline
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I suggest multiple sets of one-armed snatches with either a dumbbell or kettlebell. The world record holder for the deadlift is a Russian guy (can't remember his name right now) who set this record after breaking his back and using kb's to rehab his back. In my own experience, db snatches make my back feel better whenever it is sore. The quick motion sends a "pulse" through your back muscles-you end the workout feeling like you've had a massage. Good luck for a sppedy recovery.
P.S. Yoga is also a good idea but I'd find a good instructor first.
David Cooke
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