Question: I'm a weightlifter and I have now a lumbar herniated disc (I think it's the L5 or something). I've been under physical therapy for months and I got better. But when I returned to the gym, there were exercises that made it hurt again. I'm seeing a new doctor and he said that squats are forbidden for me. I would like you -if possible- to tell me which exercises I can do and which ones are officially forbidden for me (do you think I could squat again?). Thanks a lot!
Answer:
Thanks so much for your question!
Given your situation I am going make a few suggestions that will help you if you are consistent with your work.
First, you MUST start with core ab/back/glute and pelvic floor strengthening. You need to learn how to keep your pelvis in neutral, maintain your lumbar curve, and strengthen your internal musculature to hold you there. This will require smaller more targeted exercises that will do wonders if you take the time. In doing this you will build a foundation of strength around the injured area that you can then rely upon when doing weightlifting and other activities.
My personal favorite is Pilates, but do not just go to any mat class. If you send me your city & state I can refer you to a studio that can help you strengthen after this injury. I am not promising that you will squat again, but your chances of doing what you want to do without pain will be greatly increased.
If a studio isn't your bag then try my 30 minute MP3 of Pilates exercises for back pain. It will seem slow to you, but you will learn how to move properly when doing other exercises and that is the point.
http://stores.lulu.com/pilatestci
Try these to start--
Conscious Breathing--
Lie on your back with your knees bent , your feet hip bone width apart, and your arms by your sides. Pay attention to your breathing and to the muscles in your torso. The abdominal muscles are not just in front, they actually wrap around your torso from your spine to the front, around your
ribs, waist, & pelvis, forming the round sides of a cylinder.
Feel your ribs move to the front, side, and back as you breathe--the abdominals are helping to move your ribs! Now pay attention to your pelvis. Make sure that you are not pushing your lower back into the floor; your pubic bones should be in the same horizontal line as your hip bones--you may have an arch in your lower back and that's OK, you are
supposed to!
Now as you inhale let your ribcage, abs, and pelvis relax. As you exhale contract your pelvic floor as though you had to stop peeing, feel your abs wrap tighter around your ribs and waist like a corset, and feel your diaphragm under your ribcage pull up and under the ribs. Make sure again that you are not flattening your lower back into the mat. Do this
conscious breathing a few times.
Put your hands on your belly and notice that now it pulls in (it may feel soft, but you are going for width and depth, not for tightness!). Repeat 10-15 times.
Do this for about a week 2-3 times per day.
Pelvic Rocking--
Now add a small rocking of your pelvis--tipping it back on the exhale (hipbones back and tailbone up) and forward on the inhale (arching the lower back). Repeat the tilt/arch 10-15 times.
Do both the breathing and the pelvic rock for about a week 2-3 times per day.
Ab Curl--
Then add a curl up of your upper body on the exhale. Nod your head and then pretend you are holding a large egg or small orange under your chin (in other words keep space between chin & chest); then let your ribs drop in and down (don't shove them down!) as you curl up towards your pelvis (do not pull forward from your head at this point--use the ribs).
Stay there for a moment and consciously breathe as above, making sure that you have not tucked your hip bones back to the floor--get your pubic bones back down towards the
mat and see if you can get as deep and wide in your belly as when your head was down. Repeat 4-8 times.
Do all three exercises 2-3 times per day for 2 weeks.
Always work with pulling the belly in and not pushing out!
Arm Circles--
Still on your back with the pelvis neutral, lift arms up to ceiling, overhead, and circle around to the sides and back to your hips. It is important that your ribs stay down; it is not important that your hands touch the floor. Do 4-6 in each direction. This can also be done standing against a wall.
To add back strengthening--
Prone Hip Extension--
Lie on stomach with forehead on hands and do the same breathing as above. On exhale push your pubic & hip bones into the mat and lift one straight leg off the ground keeping the hips still and not moving your back. Alternate legs 6-8 times and then do both at the same time 6-8 times.
Flight--
Then place arms by your sides with palms down. Set up pelvis the same as above but this time lift and lengthen your head & chest while at the same time reaching your hands towards your feet and then lifting your hands/arms. Keep chest open & feet down. Repeat 6-8 times.
Do these 2-7 times per week.
Under definite no-nos I would put dead lifts, hack squats, and the leg press. Other exercises will depend on how you use your core muscles to stabilize your spine and pelvis, but these three have the greatest potential to re-herniate that disc.
I would stay away from regular squats per your physician and avoid any moves that compress your spine until you are stronger and understand how to stabilize.
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