Back to the gym with a bad back

March 11, 2007 8:49 PM

Can anyone offer advice for going back to the gym after a back injury and six months of downtime?

I hurt my back at the gym more than six months ago. It turns out I had some long-term damage to three discs in my lower back due to compression, and that contributed to the eventual blowout. There is no rupture, but there is some disc compression.

Unfortunately none of the doctors or therapists I was seeing for a while after I blew my back out speaks any English, and so I have nobody to ask about advice for getting back into shape now that I'm itching to do so. I've gained back a fair bit of weight in the last six months (from my more-or-less optimal weight of about 95kg back up to about 110kg -- I'm not obese, but I am a large lad all 'round), and I want to get back into fighting trim, and strengthen my back and core muscles. I'll be heading back to the gym in a few weeks -- planning for three sessions a week, 90 minutes or so, probably, with some walking/hiking on the weekends.

I had been going to the gym regularly for a couple of years before the injury and had gotten into the best shape of my life, so I'm reasonably familiar with the equipment and gear.

Advice for things to do, and things to avoid, in terms of equipment or exercises, as I get back into it? I'll take all advice with a grain of salt of course, since I know most of you aren't doctors, but will take all advice with thanks.

posted by stavrosthewonderchicken to Health & Fitness (15 answers total)

Wow. It's like I wrote this post circa 2001. Except I had a 12 mm rupture in my L5.

First off, do NOT pile on the weights. It's better to work with a less weight than to strain your body & accidentally twist in the wrong way. Start off very slow and build up. Even if the first few times you go you just walk for 15 minutes, take a steam and go home, that's fine. Do not expect too much of yourself at first, just do a little at a time and build up.

If they have any gentle yoga classes, look into them. (If you haven't done yoga before, I recommend trying it 2-3x a week for 3 weeks before deciding you hate it. For most people, it takes a while to actually grasp what it's about & stop feeling self-conscious.) Avoid power yoga, that's often too much for a fresh back injury. Talk to the instructor beforehand to tell them about your injury, they may have some suggestions on modifications you can do to avoid straining yourself. Yoga is really good for stretching & stuff but immediately stop doing anything that causes any pain whatsoever. It's better to sit there and just do the breathing than to do any stretch that will hurt you.

Good luck. Back injuries SUCK. Understatement of the year.
posted by miss lynnster at 9:11 PM on March 11, 2007

And if you ever get a chance to use pilates machines with a trainer, I've found NOTHING better for my injury. (I can't do the mat classes though, there's too much forward bending for my back.)
posted by miss lynnster at 9:13 PM on March 11, 2007

Response by poster: Thanks, miss l. I'm not a big one for classes and group stuff, though, so maybe yoga's out. I like to fire up the lectures on my mp3 player and zone out a bit at the gym.

planning for three sessions a week, 90 minutes or so

Sorry, I meant to say 90 minutes or so each time, for a total of 4 hours of so per week gym time.
posted by stavrosthewonderchicken at 9:23 PM on March 11, 2007

Point taken. But have you ever tried yoga? (Fruity as it may sound?) Because it might be good for your back.
posted by miss lynnster at 9:42 PM on March 11, 2007

If you look at the exercises at exrx.net you will notice that if you have a well-equipped gym there are ways to work most every muscle while your back is in a comfortable position.
posted by who else at 9:49 PM on March 11, 2007

This probably occurred to you, but there are about eight million ways to work each muscle group (outlined nicely here), and it probably makes sense to do a little experimentation to discover what hurts and what doesn't.

Also, I've found that doing dead lifts with a trap bar is much kinder to my back than any of the alternatives. Also consider trying box squats as you start to work up to heavier weights. You lose something by not going deeper, but you avoid getting loosey-goosey at the bottom of squats, which can really hurt the back.
posted by Kwantsar at 9:55 PM on March 11, 2007

I would say begin by getting back in cardiovascular shape. So, in the beginning, do a lot of jogging/running/elliptical.

Slowly work weights back in during your second week back in the gym. I'd say lift the lightest weights and keep moving up.

If you feel even the slightest discomfort in your back/disc area, stop and try something else.

I've never had a back injury, but I do know how it is to begin a workout plan when you're out of shape.

Good luck.
posted by reenum at 9:58 PM on March 11, 2007

Swim, and swim lots. Wear a waterproof Mp3 player .

Herniated discs at C5-6 and C6-7.
posted by X4ster at 10:11 PM on March 11, 2007

Response by poster: Swim, and swim lots.

Don't have that option, sadly. Looking for gym advice, here, but thanks.
posted by stavrosthewonderchicken at 10:17 PM on March 11, 2007

Sorry stavros, don't have anything else to suggest but am confident other Mefites will come up with something for you. With time and a reasonable program you can do a lot of recovering. Good luck to you
posted by X4ster at 10:24 PM on March 11, 2007

Dude. Sorry.

I recovered from something similar, with a lot of concentration. IANAD. Some thoughts:

--See a physiotherapist. Somehow. Take a translator if you need to.

--Physical therapy was a series of weekly guided workouts aimed at strengthening the core (particularly the lowest abs and the low back).

--Try this. I heard good things.

--My orthopedist gave me a single exercise to prioritize above all of the physical therapy homework. The idea was to strengthen the multifidus and the transversus abdominus muscles first, to faciliate more correct posture and support the spine.

I'll describe it at the bottom of this post, but the point is, it was a couple of months of light warmups on a stationary bike, a few specific stretches, and the physio exercises, before I was able to go to the gym and lift. It was even a couple of weeks before they said I could go on one of those weak-ass elliptical trainers--and seven months before I played ice hockey again.

There's treating the injury, and there's learning new habits, and there's building a foundation for future work. To go mess around with weights or abruptly start running would be begging for reinjury.

The feeling you're looking for, FWIW, is a loosening of the hip flexors and the psoas, assisted by gradual stretching, so that when you use your best posture you're kind of tucking your tailbone under your body. The lower abs hold you in the correct positon. This takes some time.

[May not be appropriate for you, but that exercise is: Lying on your back, feet on the mat near the butt, knees up, one hand under the lower spine. Press the lower spine to the mat, trying to crush your fingers. Don't use your legs, instead draw in your lower stomach muscles to flatten your lower back onto your fingers. Press, don't strain, hold, release. Keep breathing easily, even though it's tricky while contracting your abs that much.]

Sometime in the future you may well consider yoga. It teaches you a lot.

Best of luck.
posted by Phred182 at 12:39 AM on March 12, 2007

I've injured my back in the past. I've only had one physiotherapist that was helpful and the one thing I learned from her is core strength. I don't do the exercises all the time, though I probably should, but when my back starts getting twingy I start adding in exercise on an exercise ball. Because you have to actively balance (you can control how hard you have to actively balance) it really works well at strengthening all the muscles involved.
posted by substrate at 6:20 AM on March 12, 2007

Back in my carefree college lumbar-goddamn-disc-slipping days my physical therapist had strong advice: don't attack your back directly, but ease around it, take work off it. It's currently in no condition to do work She emphasised (especially) abs, upper legs/hips, and shoulders (to solidify posture), and was of the 'take it very slow' school re: the actual lower back muscles. (Meaning, I imagine, e.g. more hanging leg lifts and fewer twisting crunches.)

My sense is that Phred182 and substrate have the right of it - if you've been away from the gym for a while, it might take a while to nail down form again, meanwhile a period of stretching/core muscles focus will at least get you ready for your old strength-training routine.

For cardio: I should think a stationary bike (focus on posture) would be less of a strain than ellipticals, to say nothing of running?

Everyone I know who's tried yoga raves about it; though I suspect they're all crazy (and probably bloody liberals), it does seem to emphasise solidity and form in a way that we back-injury-recuperatives should appreciate - not to mention my friend in NYC who's apparently gazed upon the smiling visage of the Buddha that is not the Buddha during his Kundalini classes, or something.
posted by waxbanks at 6:46 AM on March 12, 2007

I'll nth the suggestions about focusing on posture. I've come back from back injuries before (albeit not as serious as yours) and the one thing that has helped me feel better is focusing on posture.

I'm also going to suggest taking yoga; it will help improve your flexibility and posture, and staying limber will go a long way in helping you stay injury-free in the future.

Also, everybody knows this and few do it, but use good form when you lift. Sure, you'll lift less weight, especially on squats & deadlifts, but you'll feel a lot better for it.
posted by PFL at 8:16 AM on March 12, 2007

Response by poster: Thanks, all.
posted by stavrosthewonderchicken at 6:54 PM on March 13, 2007