Fixing and Preventing Pain in the Lower Back

Snap, crackle, pop! We have all done it: If you are gonna run your race car fast, then you are gonna crack it up every once in a while.
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Snap, crackle, pop! We have all done it: If you are gonna run your race car fast, then you are gonna crack it up every once in a while.
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Snap, crackle, pop! We have all done it: If you are gonna run your race car fast, then you are gonna crack it up every once in a while. The key is to keep the damage minimal. The same goes for our training. If you are never hurt, never an ache or a pain….then you are probably not on a very progressive program. Then again, you don’t want to be hurt all the time, making reckless training decisions. What you really want to do is to get to a place where the JUICE IS WORTH THE SQUEEZE!

One of the most common injuries that tends to shut people down is that of the lower back. Funnily enough, these injuries are just as common in people who don’t really train at all. There are a lot of herniated and ruptured L-4, L-5, S-1 discs that correspond with the vertebra of the lumbar and sacral spine. Some telltale signs of this type of injury are back pain, particularly that which travels down nerves into the hip and leg. This is indicative that the injury is not muscular, but rather a ligament and disc issue that creates instability in the spine, slipping disc pressure onto nerves that exit the vertebra and run elsewhere.

I myself have fallen victim to this type of injury. Here is my story on how I hurt, recuperated and continue to treat my back:

“Don’t hurt yourself lifting those heavy weights!” That’s what I always heard from my friends and family in response to some of my CrossFit videos, particularly those who didn’t know or understand strength training. When I showed them video of a 655 deadlift, they cringed! When I told them I was going to backsquat 455 pounds every day, they said I was asking for trouble. But funnily enough, it wasn’t until last summer, when I took a break from my heavy lifting, that I ever had an issue with my back.

My yearlong dedication to backsquatting had ended two months prior. I was just chilling out from my training and concentrating on where my life was going, and my girlfriend, who was competing in the CrossFit games. I took a six-hour flight to LAX and immediately rushed to DogTown CrossFit to get a quick pump on. I wanted to wake up and look good before going an interview for a collegiate strength coaching position that my friend Josh Everett had set up. I got to DogTown and met Dusty Hyland. Jaguar warm-up — we just started throwing weight on the bar. Max unbroken bodyweight cleans and ring pushups, 5 sets. First set was good: 17 and 50. Second set I went to pull the third clean off the ground and felt something slip in my back as well as a pulling into my hip. I dropped the bar, and thought I just needed to loosen up more. I went to clean the bar again and didn’t even make it past my thigh before I got shooting pain into my hip.

“Just hop on the foam roller bro, you probably just pulled a muscle, tight piriformis you got.” But I knew better. This was a pain in my back unlike any I had felt before. Not a sore tight, overworked or achy feeling, but an acute feeling of pain and instability — kind of like walking on ice and trying not to make any sudden movement.

I went to my interview and did my best to mask the pain, moving around tentatively as the head strength coach and AD of the university toured me around the weight room and athletic department. As soon as the interview was done, I Googled a chiropractor….stupid move! Twenty minutes later I was in the office of Dr. Mike, I was a late-afternoon drop-in that he just fit into his schedule. He laid me down and jerked around my already damaged spine, getting a buffet of cracks and pops out of my si-joint, thoracic spine and neck — but my problem wasn’t alignment. I had a ligament issue and a bruised and inflamed disc. The use of this chiropractor may have exacerbated my injury.

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The next few days were miserable. Bending over or putting on my socks made me want to cry. It was ridiculous. I had to get my hotel roommate and fellow judge at the games, Dave Eubanks, to put on and tie my shoes. Getting into a car seemed impossible, and sitting was probably the most painful; it just seemed to take my breath away to try to bend anyway.

When the Games were over, I went home and just laid off my back. It seemed like a good time do some bench-press- and gymnastics-based programming anyways as I really needed to get better at my handstands. Four weeks and a 375-pound bench later, I decided my back felt OK and I was ready to pull something again. I went with some light power-snatching, which quickly turned into a 1-rep-max power/muscle snatch sesh that quickly ended when I felt the same pain in my back as I pulled 200 pounds off the ground.

This was a devastating feeling. Was I ever going to be able to lift heavy again? How would I train? I wanted to punch a wall, but moving suddenly would hurt too much. That night I put my snatching video up on Facebook to get critiqued by some Oly coaches, even though I knew it was not really my biggest issue at that point. I noted on the video that I tweaked my back on the next rep and had to stop there. It was that little comment that probably saved my spine and training, because what came next was a blessing from the lifting gods.

I got a message on facebook from a Dr. Lee Poston that basically said this: “Dave, I’m a back specialist at a clinic out here in Maui, also an avid CrossFitter and box owner at Maui CrossFit Extreme. I would like to help you. Can you tell me what you did to your back? We can do a Skype appointment and I can diagnose you.”

Well at this point, I was feeling alone and desperate, and I would take any help people could dish out. So although I wasn’t expecting much, I accepted his offer.

I met Lee on Skype. He is a lanky middle-aged guy from Tennessee — think Matthew Modine, but a little more jacked, with short hair. A super-nice, laid-back transplant out in Hawaii. I was thinking, “Man this guy is living the dream: doctor, CrossFit coach and paradise!

We talked about the injury and the way he broke it down for me was like this: “The injury to your back was not because of that particular bad pull or lift, but rather it was just the straw that broke the camel’s back, so to speak. Years of crappy position have unevenly lengthened and shorted ligaments around your spine, causing the movement and herniation of the disc toward one side. The movements that exacerbate pain are indicative as to which direction the disc has herniated, i.e., if bending forward causes pain, it is likely a posterior herniation. You can correct this imbalance through regular corrective exercises.”

We did an assessment, and like most people who herniate discs in the lumbar spine, I felt pain and referred pain when bending forward. The first thing Lee had me do was a back bend. I put my palms on the small of my lumbar and leaned back as far as I could. I felt pressure on the spine, but no running pain or instability. He said this was normal.

Lee took me through what is called the McKenzie Back Protocol, which is a series of extension-based exercises. This included press-ups on the floor (think like a shitty pushup where the hips stay pinned to the ground as the arms extend). We did about 15 of these at a one-second-up, one-second-down pace to pump fluid and get movement in the spine, and then we held the last rep for 30 seconds. The whole routine took about one minute total. Lee instructed me, “Do this eight times per day and try not to sit for two weeks, and you will be fixed, I promise!”

Well, as skeptical as I was, I stayed religious about my back exercises. People thought I was crazy, dropping to the ground while out in public, at the gym and at my girlfriends house, doing press-ups. Press-ups everywhere! It’s funny how people want to talk to you at the most inopportune moments, like when you’re on the ground out of breath, doing press-ups.

I was very tentative with my back as I came back. I started pulling off of 45, 25 pound and eventually no plates on the ground to keep my back in a super tight and extended position, bracing my belly and still doing my exercises before and after training, also in the morning when I woke up and at bedtime. What I found was that Lee was right. My back got better and so did my confidence. Later that winter I backsquatted 600 pounds for the first time. I also got PRs in my snatch and clean and jerk. But the effect of this injury didn’t stop there. I had a lot of empathy for people going through back injuries. Clients, athletes, even my own mother who had similar issues and dysfunctions like mine but which seemed to never really go away. So I started showing them the McKenzie Back Protocol, and sure enough they started feeling relief of pain! All thanks to this doctor out in Hawaii, a guy who just wants to pay it forward and help people in our community, and another example of what makes it so special.