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I have been diagnosticated with an L5-S1 disc protrusion which is less than a herniation. Most of the disc herniations occurs at L5-S1 disc, so I think it is a common problem. It happens a few months ago and now I wants to go back to gym. My medic told me to avoid certain exercises that demands using lower back like squats and deadlift. If I made a mistake I will finish with a disc herniation so I want to go slow and carefully.

I am looking for help to build a routine that helps me to gain muscle while minimize risk of lower back herniation. It seems to me that every movement uses lower back for which I was looking for exercises that may not need a strong effort from this part of the body. I have read about some variants of squats and deadlifts but it seems a little risky for me.

I am 27 years old and weights 75kg. Any suggestion is welcome.

Thanks in advance.

Edit: To clarify. I asked to doctors and physical therapists and all of them gives me some vague indications like: "Don't do squats and deadlift" or "be careful with lift weight if you are not seated" or "stretch every day" but they all agree that it's ok to go back to gym. It seems to me that if you don't have an herniation they think it is not important. Unfortunately, no one could give me precise indications of which gym exercises are better for my case. I don't know who else to ask.

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This is such a delicate question. One wrong recommendation could leave you hurt. Do you have access to, or did your doctor recommend physical therapy? That group is professionally trained to work with persons with all types of physical limitations. –  Grohlier Jan 10 '13 at 19:11
    
I agree with @Grohlier. Physical therapy will give you the best understanding of what you can do safely and what to avoid. Some therapists will take you into the gym to get you started. Also, they can help you address any other joint or soft tissue limitations that contributed to causing your disc protrution in the first place. Good luck. –  BackInShapeBuddy Jan 10 '13 at 19:46
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Thanks both for your concern. Unfortunately, each time I asked to doctor or physical therapist they answer me with something like: "yes, go to gym but be careful with your lower back", it seems they don't know much about gym exercises since they couldn't guide me more precisely, but just with some vague and obvious indications. Also when I asked the trainer in my gym, he thought I can't do any exercise and I have to explained him that my doctor told me the opposite, and then he just give me a generic routine like everyone else. I will edit my msg to make it clear. –  John Doe Jan 10 '13 at 21:56
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I'd look for a doctor or physical therapist who specializes in getting athletes back in the game, instead of those who just want to mark you as "fixed" (but unable to do normal activities). –  Dave Liepmann Jan 10 '13 at 22:28
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I agree with @DaveLiepmann. One of the keys to your enjoyment is getting back to your normal lifestyle. Dr's often take the view of "keeping you safe and healthy". Sometimes those things are not on the same page. Why live an unhappy healthy life? I suffered a lower back injury at age 12 and have had issues since. It took me over 15 years and many many many people looking at my back where I was comfortable working with someone. In this case it was a chiropractor I played basketball with and he understood that I was not going to quit activities. –  DMoore Aug 14 '13 at 15:41
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4 Answers 4

I have the exact same injury in my lower back. I am just unsure if the discs are the same. Anyhow when younger I had to sleep on a very bad bed which started causing me back pains. Later I started deadlifting and that expanded the pains to protrusions. Doctors told me that everything began with the bad mattress.

So number 1 thing for you is to make sure the mattress you are sleeping on is good for your back. The harder the mattress, the better for your back. Also when you sit down on a chair it's good to have something against your lower back so that it is resting.

That's what doctors told me and that has worked for me ever since. However they also told me to stop all back exercising otherwise it will lead to disc herniation. I did not do anything for 2 weeks to see how that's going to go and also I wanted to think things through.

The pain in my lower back would not go away. I figured that the muscles of my lower back would just atrophy if I don't work them out. That's bad since your muscles support the bone structure of your body. Hence I started working out again keeping several things in mind.

1) Any more serious pressure on your spine might lead things to herniation. That's why I replaced weights with rubberbands. I will give you an example why. Imagine biceps curling. I would curl with barbell of 50kgs. My set would be around 40seconds-1minute. During this minute the barbell would remain in my hands and for the whole minute my spine would have to cope with 50 additional kgs. And biceps are one of the smallest muscle groups in the body. I would use much heavier weights on other exercises. When using rubberbands, however, every time I go down, when curling, the bands will release the pressure on my spine. So if I am to go for 10 reps, at the end of every repetition my spine will be completely relieved from any pressure. If interested check bodylastics, I have been using them for around 3 years now and am highly satisfied: http://www.bodylastics.com/

2) Even with rubberbands however the pressure on my spine would still be a lot. That's why I replaced the position of the bands. For example instead of doing biceps curling having the bands below my feet and pulling them up, towards my shoulders, I would attach the bands above my head and pull them down behind my head. This way the bands' resistance is pulling my body up instead of pulling it down, putting pressure on the spine.

3) Bands and weights are different. I can't maintain enough strength just by using bands. That's why I focused more on body weight exercises, such as back lever and front lever(Disclaimer: both articles are written by me). These really, really strengthened my lower back and increased the size of my back.

4) Sometimes I would feel a discomfort in my lower back, typically at the end of a harder workout. The feeling is as if somebody has pressed me against the floor. So I would just feel my lower back heavier somehow. That's when I would throw some spinal extensions. There are two exercises one of the best gymnastics' coaches in my country taught me. Focus on the first exercise, I have linked you directly to it. Some of my friends have similar back problems and would refer to this exercise frequently to release the pressure from their spine. Here's the link: http://youtu.be/tVokXmC6eJM?t=33s (Disclaimer: This video is mine)

Also never forget to warm your back before a workout. Be careful with the warming up though, anything more aggressive might provoke a hernia. I hope this helped you, if you have any questions please let me know.

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I agree with the commenters on the question; saying you should be show caution with picking up new exercises with such a serious injury. I will say though, the biggest problem will be over exerting yourself. If you start with basic motions with little/no weight, and work your way up you will be fine. Avoid jerky exercises, and go for full range of motion exercises. An example of a range of motion exercise that avoids jerky motion is sitting on a medicine ball and rotating your torso as far as you can comfortably go.

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I know the feeling... I have been suffering corrosion on S1 and S3 for a long time and the first thing that got me mobile was "Yoga". I would give it a try. Simply start with "sun salutations" and simple effort and don't push it too much :)

well, the answers here also completely apply in your case, but do you also have radicular pain in below your pelvic area and your shins? In that case I would advise to make sure you strengthen your core with compund core exercises like planks on the knees, rotary exercises to strengthen your obliques. In case it radiates to your hamstrings, I would advise to strengthen your glutes and quadriceps. there are many ways to isolate those areas without putting pressure on your lumbar discs. So find out what suits you best and keep doing it till your core and key areas are strong enough to carry you further.

To build up good strength in balance you can use rubber bands as mentioned by @Arthlete or simply use your bodyweight. but make sure that your core is strong, which will make your further strengthening proces very bearable.

I would also advice to do your workouts under the supervision of a medical trainer in case you can afford it and a medical training center facility is within your reach.

It is a long journey to go and I wish you good luck in getting yourself ready...

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I had L5-S1 disc protrusion at 11 y.o. My doctors told me I can do only the swimming without risk of the secondary injury.

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