Lower back pain

If you have ever suffered a lower back injury, you know it is something you never want to experience again. I, for one, can vividly remember all the time I spent suffering with crippling back and leg pain and feeling as though I would never be able to play sports again.

My story goes back a long time, to when I was playing volleyball at College. I don't actually remember doing anything to my back during practise, but can remember the walk back to my car afterwards. By the time I got to my car, I couldn't stand up straight without pain. 2 weeks later after numerous visits to the Chiropractor I recall my roommate at the time saying to me "It can't be THAT bad, just stand up and get over it". Years later, when she suffered a disc injury, I got an apology: "Now I understand what you went through all those years ago and I'm sorry for being so unsupportive".

Unless you have suffered with a back injury, it is difficult to understand what that person is going through.

My back eventually got better but every couple of years it would flare up. The next time was when I took up snowboarding. This time I saw a Physio for treatment who explained it was my SIJ and a pelvic rotation problem. Commence "core strengthening" exercises. A couple of years later, I dove for a ground ball playing softball and once again was crippled with pain, this time the pain started shooting down my leg - "sciatica". The Physio I saw this time suggested it may be a disc bulge. I was 24 at the time. The next time my back "went" I was living in Australia and when I saw a GP demanding a CT scan to figure out the problem once and for all, he hesitated and said "I was too young for such a back problem" but relented and wrote a referral for a CT.

Turns out I had a "severe L5/S1 disc herniation causing considerable deformity of the thecal sac". Hmmm, too "young" for a back problem hey Doctor?!?

MRI of my lumbar spine in 2005.

Three visits to three different surgeons resulted in three different answers:
Doctor 1: "Let's operate".
Doctor 2: "You're nowhere near bad enough to require surgery".
Doctor 3: "I'm surprised you're functioning at such a high level considering your scans. But lets wait 6 months and see what happens".

All I can say is that I am happy that I didn't listen to Doctor 1.  Even though at the time I couldn't sit for more than 15 minutes without pain and was honestly wondering if I would ever be able to play a sport again without reinjuring myself.

Fast forward to today. I have been participating in Crossfit for 4 years and can probably count on one hand the number of times my lower back has been a problem. I am doing all the exercises I remember avoiding at the gym for fear of hurting my back eg. deadlifts, situps, GHD situps, heavy squats, etc. So what's the secret to rehabbing/"fixing" a dud back? Here are my top tips:

1. Get it checked out by a professional and don't be afraid to get a scan (CT, MRI). It is the only TRUE way you can get an accurate diagnosis.

2. Do what your therapist tells you to do. If this involves not lifting for awhile, listen to them. If they give you exercises/stretches to do - do them consistently. It isn't going to help doing them for a week then going back to training because "you feel ok". If you have a disc injury it WILL take weeks to heal. Going back to training before you are ready will only set you back in the long run.

3. STOP if you feel a "niggle" during training. That niggle is your body warning you that something isn't quite right. So many times I get told by patients that they felt "something not right" but kept going, just before they hurt themselves. Stopping in a workout will not kill you. Push the ego aside and listen to what your body is telling you. Last week I overcooked a split jerk and threw it back over my head too far and landed with my lower back extended. I felt it niggle straight away and opted to stop the workout even though I wanted to keep going.

4. Get your technique right. Deadlifting 200kg with a bent back only makes you look like an idiot.

5. Do regular mobility. 

6. Get your glutes STRONG and functioning PROPERLY. This means that they should switch ON during squats, deadlifts, kettlebell swings, Oly lifts, push ups, etc. If you feel your back during any exercise then your glutes probably aren't working properly. And if your hip flexors are too tight (from sitting all day....), your glutes probably aren't working properly.