Competitive Powerlifter hurts her back. Now what?
March 26, 2013 12:35 PM   Subscribe

(Female, 28 years old, 5'6 155#, lifting for about 5 years, 1 year competitively. First back injury.) Yesterday was my first day back to my Powerlifting routine (Texas Method if it makes a difference) after a week off for a ski trip. Within my first set of squats (after warmups) something ‘not good’ happened to my lower back (first set, 4th rep, 185#). Now what?

When I stood up from the 'bad' squat I felt some minor pain in my mid/lower back and immediately thought “Well, that doesn't feel right.” so I racked it. I rolled out on the rumble rollers for a minute, stretched, walked around the gym, etc. but eventually decided to pack it up and go home because the pain wasn't getting any better.

When I got home from the gym, I laid down in my bed for about an hour. Eventually I got up, took a handful of Ibuprofen and decided to suck it up and go to work… but the throbbing pain just kinda worsened during my commute. Walking to the office from the subway totally blew — Every wiggle of my hips was sending pain through my lower back. I got into the office, sad down at my desk, turned on my computer, and after about 30 minutes decided to go back home. I laid around with ice on my back all day yesterday, getting up occasionally to make some food and go to the bathroom. Nothing hurts when I'm laying down, but when I'm up and moving, it hurts.

It really didn’t seem that bad at first (like, hardly anything at the time) but now I’m kinda worried that maybe I herniated a disc or something (though, honestly I have no idea what that would feel like, maybe this is just what a minor sprain feels like).

I'm back at work today, though sitting at my desk is MISERABLE. I have to get up and stretch every 10 - 15 minutes or so (otherwise I cramp up and have a hard time getting back into a normal standing position).

I have a doctors appointment in two days. Any suggestions on what to do until then? Has this happened to you? What was it? How do you cope with lower back pain at the office? What is the best ways to make working less terrible?

(I know you are not my doctor. You know you are not my lifting coach)
posted by LZel to Sports, Hobbies, & Recreation (19 answers total) 4 users marked this as a favorite
Call your doctor's office and ask them for any pointers just to help until the appointment.

If you can stand at work, or kneel, or assume some other position that feels better, do so. If nothing helps, tell your boss; he or she may be more willing to let you take some off-the-books sick time if it's clear that you're not doing anyone any good by being there.
posted by Etrigan at 12:47 PM on March 26, 2013

The good news is you are young. The bad news is a back injury is just about the worst kind of fitness injury.

Absolutely positively do not do anything do aggravate it. Focus on keeping your core stable, refrain from aggressively bending or twisting. If you need to twist, do it from the waist. Try to avoid bending your back, or putting your back in a position of great torque(i.e. bending from the waist to pick something up).

I have found the golfer's lift to be the best way to pick things up, but DO NOT DO THIS WITHOUT TALKING TO A PHYSICAL THERAPIST.

To be honest, I would have considered this an emergency and probably gone to the ER. You do not really know what you did to your back, and until you do you should be extremely careful. If you did push a disc out of alignment, it may be an easy thing for the doctor to fix now, but if it is aggravated you could end up slipping a disc or worse. Alternatively, you may have just pulled a muscle, in which case you will be completely fine and will recover.

I have a standing desk at work, and couldn't function without it.
posted by jalitt at 12:51 PM on March 26, 2013 [1 favorite]

Yeah, get to a doctor. NSAIDs for pain and inflammation now, like you're doing, and they may give you something heavier duty for inflammation to promote healing.

Avoid all lifting, even a bag of groceries, until you get checked out.
posted by zippy at 1:02 PM on March 26, 2013

... and ask if the doc can see you today, or do a phone consult. They may be able to do things now that promote recovery.
posted by zippy at 1:04 PM on March 26, 2013

agreeing with the above comments, do not take any chances at all with your back.
posted by facetious at 1:07 PM on March 26, 2013

My wife suffered an excruciating herniated disk that left her immobile for 2 whole months. Recovery took a year, with relapses along the way.

It would probably make sense to get checked out by a doctor, but at the end of the day there's not much they can do.

In my wife's case, there was the option of surgery, or just letting the disc heal. The doctor recommended just waiting it out, because surgery really is only an option if your spinal column (nerve) is in danger from the protrusion.

So waiting it out by lying flat on a couch for two months was the therapy for a more serious case like my wife's.

At the very least, you're probably going to want to avoid lifting for at least three months, possibly more.

Three months into recovery, if my wife picked up our toddler or carried some groceries in from the car, she would spend the next few days in agony stretching from her back to her toes.

It's been several years now, and one thing she did do was start training, doing light free weights and the weight machines at the Y.

She also has taken up jogging (couch to 10k) and that year of sudden disability and slow recovery seems like a bad dream.
posted by KokuRyu at 1:11 PM on March 26, 2013

I've hurt my back deadlifting before, and it felt a little bit like this.

If you did what I did, you twisted your sacroiliac joint, or SI joint. It might be this if it feels very tender right around and just above your belt line, and if you feel very unstable, like if you hinged forward from your waist you'd topple over if you were holding even a small amount of weight. It also might feel like you're "twisted," and if you look at yourself in the mirror with your shirt off you might see that one hip is higher than the other. The way you described the symptoms and injury sounds like what I experienced, except that mine was more definitely "lower back" than mid-back.

In any event, in addition to ice and ibuprofen which will help reduce inflammation, I was able to get an adjustment that basically untwisted my hips and made me feel almost instantly better. A chiropractor did this for me.

But, if you indeed have the same injury I had, I have something amazing to show you: this exercise takes less than 2 minutes and has totally fixed this for me, and you can do it completely on your own.

I actually came across this just this past weekend, when I aggravated my lower back and had symptoms simliar to what you describe. I spent almost all of Saturday being miserable, then I found this Sunday morning, tried it, and I've been fine ever since.

If your injury is different, I doubt this kind of stretching would hurt you more; you've already been stretching anyway.
posted by MoonOrb at 1:18 PM on March 26, 2013 [15 favorites]

Thanks everyone, I appreciate the feedback. I'm praying it's not a disc issue. I am so not ready to accept months/years of training problems.

MoonOrb -- This sounds a lot like what I'm experiencing! I have been feeling like one leg can't quite keep up with the other when I'm walking or like it's lower to the ground or something, kinda limping (not too dramatic but definitely there). Also, I feel like I'm twisted to the right/forward a little. The Physical Therapist I am seeing on Thursday is also a chiropractor so hopefully, if this is it, it will be a quick adjustment.
posted by LZel at 1:31 PM on March 26, 2013

MoonOrb thank you for posting that video! As someone with chronic SI joint issues despite core training, this could be the missing link for me.
posted by quince at 1:39 PM on March 26, 2013 [1 favorite]

I have been feeling like one leg can't quite keep up with the other when I'm walking or like it's lower to the ground or something

If you have numbness or tingling, it could be nerve related. Get to a doctor ASAP to avoid permanent nerve damage.
posted by anti social order at 2:05 PM on March 26, 2013 [1 favorite]

yeah sorry to double-post but there is no way on earth you're going to be able to distinguish between a nuisance tweak and a serious issue - backs are funny like that - git you to el doctore pronto - if it's no big deal then you can curse us later -
posted by facetious at 2:09 PM on March 26, 2013 [1 favorite]

How is your hip, ham, and ankle mobility? How is your core and posterior chain strength? The vast majority of lower back injuries, especially when lifting, can be attributes to lower body immobilities and weaknesses.

Doctor to get the issue looked at first, but make sure whatever PT you're seeing is sports-oriented so they can check your movement patterns.

I periodically get pretty back lower back stuff going on. It helps to do high-volume, really light good mornings. I take the movement through the full range of motion but I do it VERY slowly. Initially nothing but bodyweight and I might use a wall or something to support myself on the way down. As I keep repeating the movement and blood starts going through the area, mobility usually returns and the pain lessens. Then I might add a little bit of weight--maybe light bands or just the bar.

I've recently found going through gentle yoga routines helps loosing things up a bit too. I really like this one.

The key is to do this really light stuff frequently, so you're keeping blood moving through the area and not losing range of motion. Of course, if anything starts making the pain WORSE long-term then stop immediately.

(also I disagree you can't distinguish between a nuisance tweak and a serious issue--a nuisance tweak, cramp, or minor strain will be alleviated by the routine above. A blown disk or something major will not)
posted by schroedinger at 2:13 PM on March 26, 2013 [1 favorite]

I haven't had any 'nervey' feelings at all. Just stiff, crooked, and pained to move in certain ways.

After doing more reading on the SI joint, I am almost positive that the problem stems from something there -- I have had consistent issues with my Iliac crest/hip/tailbone area and apparently that is all very closely related to the SI joint.

My hips joints are very mobile generally, but I'm EXTREMELY tight in the hipflexors. Hamstrings are incredibly strong.... possibly to the point of an imbalance. I sometimes think my back can not keep up with my legs. (squat 250, Deadlift 290... pretty close!) I have major issues with my back hyper-extending and this is something I am always keeping an eye on. From what I hear, this can be overcompensated for with hamstring strength and honestly this is probably where all my issue is coming from.

...I've got the earliest doctors appointment I could outside of the ER.
posted by LZel at 2:30 PM on March 26, 2013

I've had very similar symptoms a couple times before and from what I could tell it was just a strained erector spinae. The pain went down gradually over a few days and I used the Bill Starr Rehab protocol with deadlifts or good mornings (see section here about halfway down the page) which worked well. It's basically what schroedinger described above.
posted by Durin's Bane at 2:54 PM on March 26, 2013 [1 favorite]

Your hams are strong, but what about your glutes? If you've got hyperextension and tight hip flexors oftentimes weak and/or poorly firing glutes tend to be there too, especially if a back injury is involved. Weak glutes and tight hip flexors feed off of one another, and the combination of the two can aggravate, if not cause, lumbar hyperextension.

I have the same issue--very flexible hips, tight hip flexors, and the frequency of my lower back cramps and pains went down monumentally once I started stretching the hip flexors and doing a lot of glute activation and glute-specific strengthening work.

These things may not provide an immediate fix, but they'll make you a better athlete and decrease risk of re-injury in the long run.
posted by schroedinger at 2:54 PM on March 26, 2013 [1 favorite]

Hi there,

I'm not a medical doctor, but I have both herniated a disc and strained a back muscle (doing squats). When I herniated a disc, I had pain up and down the back of my legs, and it sounds like your pain is in your back. Here's WebMD's When to Call A Doctor (Herniated disc). If you have problems controlling your bowels, numbness, or weakness, you probably want to contact a doctor really really soon.

From what you're describing it sounds more like what I was feeling when I strained a back muscle (down to feeling tilted); the bad news is that it sucked (including pain when walking) for three days, slowly getting better for a week, and didn't really go away completely for about three weeks.

One thing that helped a bunch was wearing a back brace for a few days (a doctor once told me not to wear it for too long of a period of time because I didn't want to become dependent). Actually just tying a cloth belt across the injury site helped a bunch too. Heat/getting warm (exercise wise) helped me too.

Hope it gets better fast.
posted by Comrade_robot at 2:56 PM on March 26, 2013

Another chronic SI joint sufferer weighing in.

I see a chiropractor for my issues (in addition to recommended core strength training and other various tactics to improve my long-term prospects), and one of the things he recommended to me recently, for when things unexpectedly get "out of whack" between visits (i.e. what you and MoonOrb are describing), is a simple stretch from a standing position, where I basically keep my head and body straight ahead, and reach upwards with both arms parallel and fully extended, as high as I can (then higher), and hold it for your standard 30 - 60 seconds at a time, or else whatever amount of time does not cause you discomfort.

Optionally, while in the stretch, very carefully and gradually tilt backwards (not much, 5 degrees maybe), while continuing to reach out that stretch. It's important to keep a full extension here as you go, so you're not putting additional strain on your lower back, which will be entirely counterproductive to your goal.

I've found that doing that takes the immediate pain away, and straightens me back out, literally. My chiro recommends doing it as much as necessary, every 20 minutes even. I am not a doctor. But this works for me.

Hang in there. I feel your pain.
posted by Brak at 7:39 PM on March 26, 2013

Keep up the ice and the IB, and avoid any further strain and get your back in front of an appropriate doctor ASAP. In my own experience though, I was better off if I tried to maintain normal motions, rather than spending my days lying down.

The bad news is that once you've had a lower back injury, your back may never be the same again. The good news is that with some care, it can still serve you well. I messed up my back in a split-second while I was rollerblading when I was in my early 20s. I was miserable for a week or more, and had a few more miserable and debilitating patches over the next few years, but since then, things have been pretty good. I've done weight lifting, shifted very large rocks, moved lots of boxes and large furniture and more without incident by being very deliberate and careful about how I use my back, and aware of when I'm getting fatigued. I have had some flareups, but they've generally only been some mild pain and reduced mobility that lasted a couple of days, rather than hobbling me for a week.
posted by Good Brain at 11:52 PM on March 26, 2013

The doctor isn't going to diagnose anything (or even order any sort of radiology) until you've had symptoms for two weeks, but it's still a good idea to check in with your GP, if only so he can prescribe you muscle relaxers—it sounds like you would benefit greatly from Flexeril or something.

For what it's worth, I have a chronic back condition (two herniated discs), and I've felt maybe a dozen "oh shit" moments when something palpably popped back there... all but two of them cleared themselves up within five days. The suddenness and broadness of the injury (you can't do ANYTHING without causing movement back there, and it feels like you're completely crippled by it) makes it scary, but you've got a pretty good chance that it's just a sprain that will respond well to NSAIDs and muscle relaxers.
posted by Mayor West at 6:17 AM on March 27, 2013

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