In the depths of my back issues the chiropractor thought part of my problem had to do with the relative positioning of the left and right sides of my pelvis. The pelvis is not one solid piece, and the two sides can rotate with respect to each other. Every time I saw him he would note this and give me an adjustment.
Once I started feeling better and was developing a new exercise program for myself, I decided I wanted to incorporate some sprint work. I went to a soccer field to run 100 m sprints. I took a couple of warm-up laps, and then I hit the first all-out sprint. Here's where it gets strange. As I was running I felt this movement in my pelvis... a slip and then a catch between the two sides... like when you switch gears on a bicycle going up a hill. I thought, "God I hope I'm not screwing up my back". I continued the sprint session, and the next day my back felt... AWESOME!
So, what does this mean? I can't prove anything, but I wonder if there might be a self-corrective mechanism in sprinting. I talked with my chiropractor about it, and he alluded to the scene in Forrest Gump when, running for his life, Forrest shakes off the shackles of his leg braces - his body's attempt to re-establish its natural movement pattern. It makes sense from a survival perspective that our bodies would be able to correct imbalances through movement since there were no health practitioners in primal days. As for me, I'm not going to overthink it. I'm just gonna run with it.
After working to correct my squat pattern and muscle imbalances, the next challenge was to craft an exercise program that wouldn't re-aggravate my back. I wanted to avoid loading my back, so bodyweight movements were the order of the day - air squats, push-ups, pull-ups, bear crawls, and lunges. High reps to achieve sufficient intensity. It felt remedial, but at least I was working again. The silver lining was that doing so many air squats allowed me to ingrain the new movement pattern I had been working on.
Next, a lot of research started to come together. I had read that sandbag squats were good for addressing movement dysfunction. When I felt I was ready to load my squat I started with those, and I felt the magic. Something about the low center of gravity of bear-hugging a sandbag reinforces good mechanics. Plus, those suckers kick your butt.
Simultaneously I had read that single-leg exercises were good for back issues, and also that one particular trainer, Mike Boyle, preferred them over standard movements like the squat and deadlift for the professional athletes he trains. So I incorporated Bulgarian split squats, single-leg squats, single-leg deadlifts, and weighted lunges into my program. Another trainer used sled pushes for his athletes with back issues, so into my program they went, too.
I've still got a few more stories to round out what has gone into my comeback program, but this post is getting long so I'll save those for a future time.
Nothing saps your spirit like low back pain. It takes the fight right out of you. When I got the MRI results it was definitely alarm time. I talked to my coach. I talked to my chiropractor. I read tons of stuff online. At times like this you feel alone in your little rowboat in the middle of 20-foot seas. The fear can be paralyzing, but as the saying goes, you have to stay calm and just eat that elephant one bite at a time.
I was fortunate enough to have access to a very good physical therapist, Kevin Lulofs-MacPherson of KLUMAC PT. He impressed me with his pragmatic, evidence-based approach that placed more emphasis on tangible measurements of movement and pain rather than radiographic imaging. He identified a problem in my squat pattern whereby I was engaging in a lot of lower back extension. He also found some weakness in my hip abductors.
He put me on a corrective exercise program that focused on strengthening my hip abductors and practicing the bottom portion of my squat. I took some video of myself squatting, and that was very helpful in correcting the pattern. It's one thing when you watch somebody else move, but when your brain can see you move it is much more impactful. One practice I've picked up from this experience is to occasionally video myself during exercise. Not for posting on Instabrag... but as quality control to make sure I'm not developing any bad habits.
My back didn't start feeling better immediately, but having a program and support goes a long way in terms of your emotional state, and as my physical therapist pointed out that's a big part of the game.
An MRI seems like a great idea. Let's look under the covers, and then we'll know what's what. Right? We get injured... we get an MRI... we look at the image and say, "There! That's what's causing the pain". The problem is we're only looking at the "after" pic. What if we had taken a "before" pic... and it looked the same as the "after" pic? Now it's not so conclusive.
They did a study once. They took MRI's of people who had no current nor previous back pain. What they found is that a significant amount of them had what would be classified as a herniated disc. 30% of the people in their 30's had one. 40% in their 40's, 50% in their 50's. See a pattern? So if disc herniation is the source of back pain, how come these people had no symptoms? And now you can see the folly of the typical scenario of feeling back pain, getting an MRI, and coming to the conclusion that the disc herniation is the source of pain.
Knowing all of this, I went for an MRI anyways. My rationale was that maybe it would show my back had no disc herniations so I could rule that out, plus then I would have a "before" pic in the event that I had some future issue. So into the white cave with the ominous hum I went. The results... Richy has an L4/L5 disc herniation. Crap! Stay tuned...
Update (1/1/2018) - If you're interested in delving further into the science of how chronic back pain is likely more mental than structural check out this article.
In my last post I talked about how a back injury really got me down. Well, it was definitely a thing, but ultimately I learned a lot from the experience, and I want to share it. My "ooohh" moment was at the bottom of a back squat. It felt like an invisible plane of weakness slicing through me just above my pelvis. I got up from the squat and racked the bar. It got stiff real fast, and I was walking around like Redd Foxx. I call it the "Sanford & Son feeling". Bamp bum banna...
The pain and stiffness diminished somewhat, and after about a week I resumed exercise, but it was still present. A short while later I tweaked it again, and the pattern repeated itself. This went on for a few months until I acknowledged that I needed to address this issue. Of course, I had already been trying every lower back stretch I could find, but clearly that wasn't fixing the problem.
So what does Richy Rich do next? He goes for an MRI. Stay tuned...
As I noted in my last post, I've had some pretty bad writer's block over the second half of this year. Not surprisingly it coincided with a back injury. As most exercise enthusiasts will tell you, injury is often a quick route to depression. It's understandable that not being able to participate in an activity you enjoy is a downer, but injury can also wreak havoc on your psyche. Is my body breaking down? Am I getting old? Is it all downhill from here?
Over the next couple of weeks I'm going to discuss some of the things I learned while dealing with my back injury. But the most important lesson is a philosophical one. Nelson Mandela once said, "No matter where you find yourself, there is always journey ahead". Life isn't fair, and we can certainly find ourselves in disheartening situations. Once you accept your reality you can then get to work. The work may get you back to where you were... or it may involve transformation. It is this work wherein lies the salvation.
As my readership of three can tell you, I've had classic writer's block for some time now. The book The War of Art is about our inner battle with a character the author calls Resistance. Resistance is very crafty - sometimes posing as your friend... other times your harshest critic. Regardless of the form he takes, at his core Resistance is the voice of self doubt.
Resistance can never be vanquished completely, and the more he wins the stronger he gets. It is a lonely battle, but sometimes we get unexpected help. My stagnated blog recently got a new reader who let me know how much the story of Ugly Becky touched her...
"Your writing is genuine, wise and and to me, captivating. I find so many people posing as motivators who are lacking the gifts of humility and believability. You have those gifts."
In an instant all the carefully placed papers of self doubt were blown off Resistance's desk. Oh, he was furious! That's right... I'm back, baby. But more importantly, I am reminded of the positive impact our words can have on each other.