Lumbar Disc problems: These are tricky. Only because too may people blame the disc for everything. Does you leg hurt, it’s a disc. Does your back hurt, it’s a disc. Does your foot hurt, it’s a disc. Did your wife leave you for a faster runner, it must be your disc.
Really important: Pain in a person’s IT Band is FREQUENTLY diagnosed as a lumbar disc problem. Nerve pain from a disc problem travels down the leg in a spiral pattern, sort of like a barber pole. If you have pain which travels from your hip bone, down the outside of your leg to just below the knee joint, there is a good chance you have pain in your IT Band. If you are not sure, go to the section on IT Band pain and complete those self-tests and try treating your IT Band before you talk to a back surgeon.
History: USUALLY, a gradual onset. But a fall can cause a bulging disc. Most disc problems usually follow a pattern. You have a lot of pain when you wake, it gets better as the day progresses but then you more pain later in the day. Each disc causes pain and weakness in a specific area of the leg. If your whole leg hurts it is probably not just one disc. Our nerves travel down the leg in a spiral pattern like a barber pole. Pain straight down the outside of the leg from the hip bone to the outside of the knee is probably your ITB not a disc.
Evaluating pain from a disc is one of our highest skills. We have to eliminate all the false findings and identify the disc as the true source of your pain.
Self-exam: Look for these things:
1) Stand in front of a chair. Try to complete five forward bends. If your pain increases, stop. VID
2) Now, while standing in front of the chair, complete five back bends. If the forward bends increase your back pain and the back bends decrease the pain, those are very good signs you have a lumbar disc problem.
3) If those two tests are positive, I HIGHLY recommend you see your physical therapist before beginning any of the exercises below.
Treatment: This is one time when we recommend taking a break from running. At least cut back your running while we try to fix (reduce) the disc. Change to a different form of exercise, BUT NOT BICYCLE! You may change to swimming or pool running. The exercises for a bulging disc usually include back extension exercises and pain management. We need to make sure you do not have any weak or tight muscles which contribute you your disc problem.
1) Most exercises involve minimal movement of the back to reduce pressure on the discs as they recovers
2) These exercises are usually done with the spine in a neutral position and progress as you get stronger
Treatment:
1) Manage the pain:
a. NSAIDS will help.
b. Kinesiology taping to your back muscles may relieve your pain. LIN
c. Ice or heat can relieve your pain.
i. Ice right after you get done running
ii. Heat on non-running days
d. Continue running but avoid aggressive speed work and hill repeats, especially downhill running.
2) Restore full motion:
a. If you have pain from a lumbar disc, this website is NOT a resource you should use. Please see your physical therapist for a complete evaluation and follow their specific exercise program.
b. Stretching does not have to be part of your warm-up or cool-down. But it HAS to be part of your training program. LIN
3) Once you have been cleared by your physical therapist, here are exercises to strengthen your core.
a. Crunches, bridges, plank, super persons (Politically correct), the selection is endless. VID
b. You can add exercises like side plank, bicycle, plank punches, single- leg bridges, bicycles, or Russian twists, etc. to your routine if they do not hurt.
c. You could stay at this level for a long time.
d. HERE IS THE MOST IMPORTANT PART OF CORE TRAINING. Find something you like to do and do that exercise a lot! If you do not like an exercise, you will find every reason in the world to skip it.
4) Once you have been cleared by your physical therapist, you may begin body weight exercises with emphasis on control versus strength and power.
a. There are literally hundreds of exercises which include the legs and the core. If I get a lot of requests, I will make a video specifically for those exercises.
b. One important activity which should be included with all leg injuries. BALANCE EXERCISES! It is amazing how quickly our balance deteriorates after any injury to our lower extremities.
c. Click here for video to know if you are ready to progress to more aggressive exercises.
5) Correct running mechanics.
a. Gradually return to your previous running. Start on relatively flat ground or even on a treadmill. The best part of returning to running with a treadmill is that you can actually hear your footsteps. Also, a lot of treadmills are in front of a mirror so you can see your hands move and your feet move. If your arms or legs swing weird, you may want to have a physical therapist complete an evaluation before you return to full running. Listen and ‘feel’ how you run. Is one leg hitting the ground harder than the other? Does one arm swing differently than the other? Until you can run without pain and with fairly symmetrical running mechanics, you are still at risk of reproducing your old injury or creating a whole new injury to another part of your body.
b. As soon as you can run without pain and without a limp you can return to your normal running routine.
6) Return to running speedwork and hills. After you have been able to run on flat ground for a week with your with your normal training and have not had any pain, you can begin to add speed and hill training to your program.
7) My favorite step, get back to full running! Have fun. Eventually you will bust something else and be back to the website to fix that.
8) If you follow the steps on the website for 2-6 weeks (depending on how badly you hurt yourself the first time and on how long you tried to ‘run through the pain’) and your problem does not resolve, then call our clinic for an appointment and we can do something Dr. Google cannot do. We can complete a hands-on evaluation, in-person evaluation to determine the cause of your pain.