What is a good AB workout with injured L4 & L5 discs?

  • speedoguy53

    Posts: 124

    Dec 28, 2006 10:25 PM GMT
    Was wondering if anyone out there has some suggestions for getting the old belly a bit tighter when you've had back disc problems in the past. I'm afraid wrong twists, turns or lifts could pop the discs out again.Is there anything safe?? I lap swim regularly for my workout of choice. Thanks!
  • UStriathlete

    Posts: 320

    Dec 29, 2006 4:39 AM GMT
    definitely find a good pilates instructor to help you. find one that works with back injuries if possible, and works with you in nuetral spine (meaning not a flat back or hips tuck under, you do want a small curve in the lower spine) think of your hips as a bowl, you don't want the water tip out either front or back. hope that helps some.
  • art_smass

    Posts: 960

    Dec 30, 2006 12:15 AM GMT
    I had the same problem a few years back. When I first got hurt, I stopped doing anything for a couple of months as my doctor ordered. I had been teaching spin classes and a bunch of other strength classes for more than a decade, so taking any time off was a bummer. I gained weight fast, but my doctor insisted that I give my back a rest before he could prescribe an adequate course of treatment.

    Once I got back to the gym, I started hitting the Lifefitness Crosstrainer hard. If you hold your feet flat (don't do it on your toes) and keep your abdomen compressed, you put your body in a position where your core is constantly engaged. Even better, that position allows you to retract your shoulder blades and utilize your arms more efficiently, making the motion a genuine cross-training experience.

    After a couple months of that, I began to get back to weights and abs. I kept the ab work safe by avoiding anything with a large range of motion (ie: roman chair, laying leg lifts). Herniated lower-back disks don't seem to respond adversely to light twisting, like simple oblique crunches, but avoid anything that loads up your back, like a back extension apparatus.

    Moving into the weight room was actually more difficult. For a while I learned to avoid flat benches out of necessity, and I stopped spotting people. About seven years later I'm lifting more weight, doing some ballistic stuff, and leading spinning classes, etc. I kept it simple for the most part, and I listened to doctors -- not yoga instructors and chiropractors. I know that sounds dismissive, but it worked for me. I agree with the Pilates suggestion, though. Just be sure to assess your new limits. This is an injury that you learn to live with. Getting your core stronger is the first step.
  • speedoguy53

    Posts: 124

    Dec 30, 2006 4:41 PM GMT
    Thanks alot for your response guys! You both confirm what someone else had mentioned to me.....that pilates is the way to go and therby strengthen my core.....now my new year's resolution will be to find a class in or around Sarasota, Florida!
    Thanks again men!
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    Mar 16, 2007 9:55 AM GMT
    Do not do too much of the external abdominal muscle groups (the obliques, rectus) but concentrate on the transverse deeper levels of abdominal group in addition to your back (multifidus), which can only fire with isometric rotation, not extension (no dead lifts.)
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    Mar 16, 2007 10:07 AM GMT
    Excessive work on external ab muscles canincrease intra ab pressure, creating ValSalva, sort of like the same thign when you sneeze... that will do a number on discogeneic dysfuntions...
  • vicguy

    Posts: 4

    May 01, 2007 9:11 PM GMT
    Be careful about Pilates teachers who still teach "imprinting" of the lower back. Avoid rolling like a ball; roll ups; roll overs; and short spine on the reformer. Never stretch your hamstrings with a rounded lower back. The lumbar spine should be kept in neutral, natural alignment. That means that you should always maintain the natural lordosis of the lower back. Some teachers will tell you to press your lower back into the mat when lying supine. This is contraindicated for lower back injuries. Read Stuart Mcgill's reasearch from the University of Waterloo. He comes up if googled.I've been teaching Pilates since the early '80s (before it became popular and heavily commercialized) and used to be a professional ballet dancer. I never leave the neutral position when I work out; weight workouts included.
  • atxclimber

    Posts: 480

    May 01, 2007 9:29 PM GMT
    As usual, I will recommend a good Iyengar yoga teacher. A good Iyengar teacher will be able to give you poses and sequences that will strengthen muscles without endangering your lower back, and if you can find a particularly advanced teacher (someone who's been teaching for 15 years or so) that teacher will be able to give you a more subtle practice that will really help rehabilitate those vertebrae and all the tissue around them and move you back towards 100%.

    Mr. Iyengar visited SF for his 87th birthday a few years ago and there was a big reception and all, and talking to some of the people who've studied with particularly advanced teachers, the recoveries are pretty amazing. One woman in particular had some kind of surgery after messing up her lower back really badly -- it was this surgery where they opened her up from the front *and* the back, put in all these pins and metal and stuff, and she said even 2 years after that she was unable to lean forward enough to touch the ground, even with her knees fully bent, and everything was just total agony.

    She developed a super-diligent Iyengar practice just because she didn't have anything left to try (with, obviously, an incredibly senior teacher -- most teachers would be terrified to work with someone in that situation) and when I talked to her, she seemed totally normal. Said she can jog again and everything. It'd been about 10 years of practice, I think, but still... her doctors had basically told her they were giving up.

    Not to sound *too* much like a "true believer" syndrome kinda guy, but I'd sooner trust my health to some of my more senior teachers than any medical doctor I've ever gone to. :)

    (NYC's advice on my recent knee injury, to be fair, was extremely useful and spot-on, so I'm not putting down the medical profession, just saying that I've found enormous benefit in the Iyengar system whereas many times when I've visited "Western" medical doctors my luck has not been as good. That may just be because the Iyengars are super-anal about certification, and so there are just fewer of them around!)
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    May 02, 2007 12:13 AM GMT
    Discogenic problems are the most difficult to treat... You were not very specific about your injury, you only indicated levels. It is hard to tell if you have an actual prolapes, also known as herniated disc, or bulging of discs, or dessication of discs. Even then, unless you show me the actual MRI, it is still not specific enough as the buldge or herniation can be central or near the nerve root byt the formen, superiro to the actual nerve root or inferior to it, slight bulge or severe whcih can be sequestered... And MRIs are not taken in weight bearing positions. Additionally, many patietns have shown suymptons completely inconsistant with MRI findings. Many more even show in consistant physical exam findings from exam to exam...

    Additionally, the pain you feel is NOT the discs as they have no nerve supply. The pain is always from the actual tear of the annular (the outter layer of the discs) or impingement of surrounding tissue from the inflammatory response after an annular tear or HNP. THAT IS ALSO WHY somtimes the MRI will come back all normal but the patietn would ahve severe knife like pain because there is a PRE-DISCOGENIC SYNDROME when the annular is starting to tear, but the acutaly bulging or herniation has not occured yet... THE DISCS THEMSELVES DO NOT HURT...

    THAT IS WHY A LOT OF DIAGNOSIS AND TREATMENT FOR LBP ARE INCONSISTANT...

    The key things to remember:

    1. If you lift heavy weights, standing or in any position, the tendency is to hold your breath as in ValSalva so the trunk is stabilized. This is ver common but it not only increases your BP, but can increase intra-abdominal pressure, making any discogenic impairments WORSE...

    2. Traditional position distration or compression theories are proven false as a form of treatment in the latest studies performed on fresh cadevers. However, mechanically speaking, some positions do put more pressure on the discs. They are trunk flexion and rotation most of the time. Extension is not always the shake and bake answer as it can sequester disc material. Running can also put more axial presssure ont he disc and cause the annular to tear more. So any thing youahve to bend your trunk forward, rotate it, or runningis not a good idea.

    3. You just cannot work out effectively UNTIL your discs have healed, and they do.

    They heal poorly if they are not hydrated well, such as in the case if you are a smoker... Some studies suggest stress can indiretly cause this as well.. To promote healing, you just ahve to avoid the activies and positions mentioned above.

    4. After they have healed, the wise thing to do is to start re-building the muscels that hold the vetebrae joints togehter, and gain trunk and LE felxibility to unoad the joint under certain situations. This can be done through Yoga, Pilates, PT, etc... The muscles that gives spinal joints stability are the transverse abdominals and the multifdus. Multifidus , althought oblique, do not perform gorss trunk rotation but as they are very short and almost horizontal between 2 or 3 vertebrea, they can only be activated by a certain specific exercises. Ask your PT (make sure he is a GOOD one, there are lots of BAD ones out there) to show you how. Many Yoga and Pilates exercises already inherenetly stretch and exercises these muscles... Maybe that is why they do work very well...
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    May 02, 2007 12:22 AM GMT
    By the way, THANK YOU ATXCLIMBER!
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    May 03, 2007 10:39 PM GMT
    I also suffer from disc problems. I have never had an MRI because my insurance would not cover it unless I went to a spine surgeon which I was not willing to do when I was just 20 years old. I was barely able to walk for a week or two and for a long time had shooting pains in my back and legs, that would come about just sitting in a chair. The only thing that got rid of the pain was Vinyasa yoga. after doing yoga for about 2 months, all of my back and leg pain was gone. I did yoga once or twice a week, and would then go sporadically. the movements in Vinyasa yoga tend to be very good for the lower back. I will say that you have to be careful, start easy and not do anything that doesn't feel right, it will all come together in the end. It also happens to be a great workout.

    Vinyasa yoga is known more for the flow and movement between poses than Hatha yoga which is characterized by holding positions for extended periods. Hatha yoga I have found exacerbates my back issues.
  • xbuffed

    Posts: 41

    Aug 17, 2009 6:00 AM GMT
    chungo44 saidI also suffer from disc problems. I have never had an MRI because my insurance would not cover it unless I went to a spine surgeon which I was not willing to do when I was just 20 years old. I was barely able to walk for a week or two and for a long time had shooting pains in my back and legs, that would come about just sitting in a chair. The only thing that got rid of the pain was Vinyasa yoga. after doing yoga for about 2 months, all of my back and leg pain was gone. I did yoga once or twice a week, and would then go sporadically. the movements in Vinyasa yoga tend to be very good for the lower back. I will say that you have to be careful, start easy and not do anything that doesn't feel right, it will all come together in the end. It also happens to be a great workout.

    Vinyasa yoga is known more for the flow and movement between poses than Hatha yoga which is characterized by holding positions for extended periods. Hatha yoga I have found exacerbates my back issues.


    I just saw this post, as i have a similar issue and appreciate the yoga advice. Are you still pain free? Did you ever find out what was wrong with your disc?
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    Aug 17, 2009 11:07 PM GMT
    Like xbuffed, I have similar problems and would be interested in hearing the answer.

    I'm also going to post this link (which I've posted before in a couple of other threads) that discusses ab work causing back problems and that includes a video demonstrating alternate exercises that shouldn't cause problems:

    http://well.blogs.nytimes.com/2009/06/17/core-myths/?ref=magazine
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    Aug 20, 2009 2:16 PM GMT
    In response to your questions.

    I am still completely pain free. the only time I have any pain seems to be after I do serious manual labor. I no longer am doing yoga because of separate knee issues but the benefits have remained.
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    Aug 20, 2009 8:32 PM GMT
    Thanks for the response, chungo! Glad to hear that you're no longer in pain.