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I realize this is a complex medical issue, but I've been frustrated with my lack of progress. About two years ago I was finally struggling enough with my back pain (difficulty standing for long periods, pain when lying flat, difficulty due to pain when getting out of bed, etc) that I decided to visit a therapist and have some x-rays done. They found that I have degeneration between the L5-S1 discs. I was told that many people have this specific degeneration and that it really depends on the individual and how they react.

According to the PT, some walk around completely oblivious to it while others have major difficulties. Fortunately I have progressed to somewhere between these two camps. I can perform squats but I have some difficulty with keeping my back straight while lowering. I have reduced the weight significantly in order to perform them correctly (or as best I am able). Surprising to me is that planks, even on my elbows, are extremely difficult. I'm not sure if this is a function of simply building strength or due to the degeneration. There is some pain while doing them. Given this information, I'm wondering what people do since the general recommendation is to build strength and flexibility since there is no 'cure' for this.

Should I just be patient and keep at it? Are there any ideas of what I can expect for progress?

Thanks for any information!

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closed as off-topic by Lego Stormtroopr, FredrikD, Freakyuser, K.L., JohnP Jul 29 '13 at 14:57

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Have you checked back with your therapist for a recent assessment and an update of your exercises to address any changes in your condition? As far as what you can expect, it depends on the individual as you have already noted. –  BackInShapeBuddy Feb 28 '13 at 3:34
    
I am trying to see if I can reach a small level of gains prior to seeing him again. Once I've exhausted my options I'll schedule again. Thanks for the comment. –  McArthey Feb 28 '13 at 18:48

2 Answers 2

I do not have the exact same affliction that you have but mine is in the same area (connective tissues) and has the same needs.

Squats were always the bane of my workouts. I consider squats the most important lift to do yet it was the worst lift on my lower back. A few years back I was squatting up to 550-600 on heavy days. 2-3 times a year my back would go out. Normally in pain for 2-3 days.

After careful monitoring I found the following to be reasons that added to lower back pain (or throwing my back out):

  1. Gaining weight - if I had 10-20 extra pounds on the chances of my back going out went up exponentially.
  2. Dehydration
  3. Improper technique - especially on squats but got hurt doing a few other movements.
  4. Lifting after cardio/sports. You do not want to lift with "loose" muscles - or lift heavy.
  5. Not doing enough core work.
  6. Long periods of inactivity.

How I dealt with each:

  1. Lost the big muscle body and some fat. My body couldn't handle the body builder physique at all. I started jumping rope again. It is a great low impact core workout that trims. Two feet down - two feet up.
  2. Drink before and during workouts.
  3. I switched from high weight to quick sets. 5 sets of 12-14 reps at a fraction of the weight with 30-45 seconds in between. That way I could focus on technique and still get a good workout in (harder).
  4. This is something that I still don't practice - hard to lift before basketball.
  5. I do abs 4 times a week. I also do side bends at 45 degrees and good mornings. I have been explicitly told not to do good morning but nothing strengthens the lower back better - IMO.
  6. I won't go more than a couple days without at least jogging no matter what. Blood flow and muscle use is key.

And I would suggest looking into seeing a chiropractor that specializes in seeing athletes. I have a great one in my area. He not only treats my lower back issues but also sets realistic boundaries for me. Every doctor I saw gave me a laundry list of things I couldn't do. Their goal seemed to be that I never have to see them again - not that I will enjoy my life.

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I made a quick reference here to look at nerve innervation originating below L5. Your abs should not give out due to the degradation and a loss of innervation. If the degradation was causing the problem it is much more likely that your glutes are giving out. Since they are a major stabilizing muscle this is a viable possibility. You should definitely strengthen your core (abs, back, obliques, etc.). Remember to stretch too, though. Having tight muscles that attach to the pelvis (hamstrings, piriformis, gultes, etc.) can pull the pelvis out of alignment. In turn, causing mal-positioning with your back and hips (which then affects the rest of your body).

When doing squats, maybe try using a weight-lifter's belt. While your body is out of balance you should try to assist yourself while possible. All the while, training those weaker muscles to rely less on the assisted devices.

Remember that pain is bad. If something is causing sharp pain, STOP. And as always, consult your PT or a Physician if you are unsure if you should continue to exercise.

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I try to stretch regularly but I do neglect my ab work. Thanks for the reminder since I (intellectually) know that a solid core is important. Executing this is another thing entirely. –  McArthey Feb 28 '13 at 18:49

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