Low back pain - from 'fragile' to skiing shape?

I have a history of low back pain - first had that awful 'pop' circa 2009. Had it happen periodically till it popped really bad in 2015 and did not get better, while I was deployed to Australia. Finally got an MRI, had both a bad herniation at L5-S1 and a tumor in my spinal canal (schwannoma, benign). Tumor resection + microdiskectomy in 2015, full recovery for the remainder of my time on active duty (deployed again as an infantry officer, to Syria).

Had my next 'pop' early in 2018, in the gym. Since then, it's been every six or so months. I have tried to be proactive - I workout regularly (4+ times / week), get acupuncture through the VA, just had my first steroid shot. A follow-up MRI has shown a bulging L4-L5, some reherniation at L5-S1, and spinal stenosis (narrowing), as well as generalized degenerative disc disease.

I've tried a number of PT regimens - the regular PT (feels too easy), Mountain Tactical's lower back pain (was good for awhile), Foundation Training - in hopes of getting that strong/confident feeling back. I wake up feeling like an old man (I'm 32), and I have that persistent 'fragile' feeling. I can lift/workout/do controlled things (road cycling) fine most of the time - including still being an infantryman in the reserves - but I'd love to get back to a place where I can be athletic in a dynamic environment. Last time I tried to ski (January of last year), it twinged hard on my 3rd turn, putting me flat on my back for about a week with big painkillers and muscle relaxants.

I want to ski again, and I want to get ahead of this in a manageable way so it doesn't prevent me from being an athlete. Any recommendations as to building back that stability/confidence/ability?

I've had similar issues and have made great progress. L4-L5 smashed up and arthritis for 2.5 decades and wrestling and coaching. I doubt the exact same things that have worked for me will work for you, but I think some of it will apply.

-Stop doing exercises that occasionally hurt your back. Even if it only aggravates things twice a year, quit it. I don't squat any more, and I don't deadlift heavy, and I don't ride a road bike. And I sure as hell don't wrestle. Even if the lifts I replace them with aren't as effective, I stay stronger in general by avoiding injuries.

-Do core and glute exercises (and whatever else your PT recommends to protect your back) at the beginning of your workout, not at the end. This switch was big for me. Managing a lifelong injury that takes precedent over max strength. At the start of a workout you're more fresh, more focused.

-Don't lift to failure. No more 1 rep max. Not worth it.

-But yes, you need to lift because...

-Core and glute exercises- these are what keep my back feeling good. My lower back, despite the arthritis and general smashed-upiness, is plenty strong. But when things aren't lined up right it hurts like hell. Working on my glutes (especially glute med) and core keeps me limber and straight. I've tried cutting back on lifting and running more at times, and I get faster, and have more endurance, but I eventually have more back pain. Maintaining baseline strength is key with core and glutes 1a and 1b.

-When you add new exercises, do it very cautiously. If you take a week or two off from lifting, reduce the weight more than you want to.

-Stretch your whole fucking body. Deeply. 2-3 times a week. I like to smoke a bowl first. Helps me relax through the pain without over-stretching. Then I go to bed.

-Figure out sleep positions that are better for your back. If I sleep the wrong way I wake up with my hips out of alignment. I often sleep on a couch because the fact that it is narrow makes it harder for me to get into a position that I find comfortable, but leads to back pain. It's weird, but it works.

-When your back does get fucked up: dry needling/ acupuncture isn't always pleasant, but it can be miraculous. A massage is far more pleasant, but nothing can relieve knots and get me back to normal faster than a needle.

-Lose weight if you need to. Extra weight just adds stress on your back.

-Try another PT. Then another. Then another until you are happy with where you are. I've seen a bunch of good ones that I've learned from. Now nobody understands my body better than me, but I couldn't have done it without their help. Try to find someone who works with athletes. Better yet find someone who was/is an athlete. Best I've worked with was a former pro bike racer. She understood me, not just physiologically, but psychologically.

5 years ago I thought I was going to need surgery or just lead a less active life. No I feel pretty fucking good.

Good luck.

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Originally Posted by I've seen black diamonds!

I've had similar issues and have made great progress. L4-L5 smashed up and arthritis for 2.5 decades and wrestling and coaching. I doubt the exact same things that have worked for me will work for you, but I think some of it will apply.

-Stop doing exercises that occasionally hurt your back. Even if it only aggravates things twice a year, quit it. I don't squat any more, and I don't deadlift heavy, and I don't ride a road bike. And I sure as hell don't wrestle. Even if the lifts I replace them with aren't as effective, I stay stronger in general by avoiding injuries.

-Do core and glute exercises (and whatever else your PT recommends to protect your back) at the beginning of your workout, not at the end. This switch was big for me. Managing a lifelong injury that takes precedent over max strength. At the start of a workout you're more fresh, more focused.

-Don't lift to failure. No more 1 rep max. Not worth it.

-But yes, you need to lift because...

-Core and glute exercises- these are what keep my back feeling good. My lower back, despite the arthritis and general smashed-upiness, is plenty strong. But when things aren't lined up right it hurts like hell. Working on my glutes (especially glute med) and core keeps me limber and straight. I've tried cutting back on lifting and running more at times, and I get faster, and have more endurance, but I eventually have more back pain. Maintaining baseline strength is key with core and glutes 1a and 1b.

-When you add new exercises, do it very cautiously. If you take a week or two off from lifting, reduce the weight more than you want to.

-Stretch your whole fucking body. Deeply. 2-3 times a week. I like to smoke a bowl first. Helps me relax through the pain without over-stretching. Then I go to bed.

-Figure out sleep positions that are better for your back. If I sleep the wrong way I wake up with my hips out of alignment. I often sleep on a couch because the fact that it is narrow makes it harder for me to get into a position that I find comfortable, but leads to back pain. It's weird, but it works.

-When your back does get fucked up: dry needling/ acupuncture isn't always pleasant, but it can be miraculous. A massage is far more pleasant, but nothing can relieve knots and get me back to normal faster than a needle.

-Lose weight if you need to. Extra weight just adds stress on your back.

-Try another PT. Then another. Then another until you are happy with where you are. I've seen a bunch of good ones that I've learned from. Now nobody understands my body better than me, but I couldn't have done it without their help. Try to find someone who works with athletes. Better yet find someone who was/is an athlete. Best I've worked with was a former pro bike racer. She understood me, not just physiologically, but psychologically.

5 years ago I thought I was going to need surgery or just lead a less active life. No I feel pretty fucking good.

Good luck.

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Good stuff ^^

I've found that front squats do not aggrevate the l5s1 issues I deal with, whereas back squats give me nerve / leg pains at night...

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ever try any yoga ?

they now have have yoga classes in the oil & gas camps up in narthern Alberta

My yogini looked at a ski bro and said out of the blue wow that guy looks hurt,

i said buddy got hit by a tree how did you know he was injured ?

she can tell by looking

I've got a bad back with spondylolisthesis and a variety of other commotion. Yoga has allowed me to get back to playing hockey, golf, tennis, skiing... all types of dynamic twisting motions feel fine. I have more energy now than I did before I started my practice ~17 years ago. Plus, I lost ~25lbs

I've seen black diamonds - much of what you say is very much on point for me, especially the tension between NEEDING to lift (otherwise your back will *definitely* twinge) and the fact that lifting can sometimes be the trigger for a twinge/spasm. I had hoped that COVID (and it's transition to much more bodyweight/my 45lb kettlebell/40# ruck based workouts) would be a good push in the higher volume, lower risk (vs the old favorites of deadlights and hang cleans) workout department, but where I've ended up is a back I can lift with, yet never really feels 100%. I would echo the dry needling/acupuncture bit as well - can take days/weeks off the recovery time when the back is feeling bad.

What I'm really trying to wrap my head around is - do you have any good programming that builds to that sort of generalized strength/confidence/etc?

There are definitely things I need to do more of - and know it - i.e., bikram (pre-COVID) used to be a huge help, regular massage, really need to get my hip flexors and IT bands working/lengthened to reverse my anterior pelvic tilt / stop overtensioning my hamstrings and over-pressuring my back.

In the foundation training (which is good, but not enough) free video, he promises "do this 12 minute routine everyday and you'll have no back pain, ever again." I tried that for about 4 months - before my back spasmed again as bad as it's been post-surgery. If there's *something* I can do - consistently and regularly - to get that sort of effect...

I've been in the same boat for the past 16 months or so.

My PT gal finally broke her facade and said "AR, you are 35...", before quickly putting the facade back on.

Honestly, I'm glad she did. Chasing the dragon of how you felt 10 years ago as some young buck is a fool's errand. Stretch religiously, work out your core, and quit lifting any substantial weight. Seriously, it isn't helping.

Take up swimming, its worked the best so far for me.

Every once in a while my lower back hurts out of a adjustment, and a visit to the chiropractor does it.

But it only happens if i slack on my core routine, which is 5 times a week of planks, 60 seconds and crunches, 400.

To keep my lower body strong, i do électro stimulation for quads, hamstrings, butt and calves. This is pretty intense, can't watch tv while you're doing it.

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I went through this in my 20s following a serious car crash. Whatever path you find works best, the fundamentals are gradually and determinedly exploring your limits of both strength and flexibility, without aggravating your underlying condition. Initially you’ll inevitably focus on your limitations, but the habits you’ll acquire will pay dividends as you age.

I've posted it here a few times, seldon, and I don't think anyone has ever bothered trying it - St. John's Wort oil on your spine everyday for a year. I had a litany of shit it seems to have cured.

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Originally Posted by kootenayskier

(snip)Whatever path you find works best, the fundamentals are gradually and determinedly exploring your limits of both strength and flexibility, without aggravating your underlying condition. Initially you’ll inevitably focus on your limitations, but the habits you’ll acquire will pay dividends as you age.

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This sums up my experience over the past ~ 8 years and echoes the advice I usually give to people who are having similar problems. Initially I was too afraid of activity, I wasn’t doing enough and now I believe I didn’t get better as quickly as I could have.

I’m not totally out of the weeds yet, and may never be. I still have acute episodes, maybe 1–3 / year, but they are further and farther between. It tends to really act up in December, for whatever reason. But I don’t feel fragile anymore and I’ll push my skiing if I feel right on a given day. A handful of years ago I was in so much pain and so discouraged that I didn’t think that would possible.

The upside, as other posters have mentioned is that I had to make changes that have positively affected my life and fitness pursuits. I’m down ~25lbs from when the incident occurred (down 45lbs if you include the weight I put on after the injury) and I don’t think I’ve ever been this flexible. I have a seasonal routine that works for me. My core feels as strong as when I was got to ski Squaw every. I believe my body works in better harmony than ever before because I’ve been forced to think about it.

Agree with the critical importance of core strengthening, but other things to consider is changing how you ski. The combination of twisting and high impact is to be avoided. Things to consider, some of which are intuitive:

1. You can ski bumps, but stick to softer ones and use your legs to absorb rather than your low back.
2. Avoid jumps - the landings will be hard on you
3. Avoid skis stiffened with metal - they are popular on this forum, but you need the ski to absorb some of the terrain; if you'd like a ski for firmer conditions, choose one with a bit of carbon fiber (it's more forgiving)
4. Consider a twin tip ski - it lets you control the turn shape so that you can protect yourself (you don't want the tail locking you in)
5. Avoid some of the modern skis that have TOO small a turn radius - you don't need a charger, but a more low to mid-20s turn radius can help. You can always skid a turn to make it smaller when need be, but you don't want the ski controlling the twisting motion as the radius gets smaller.

Best of luck!

I was actually about to circle back here to add that I didn’t touch anything but damn-near-perfect moguls for 3-4 years and I changed my preference from metal laminate, rear-mounted Stockli-style skis to twin tips / reverse camber to accommodate a more upright centered stance. Now I don’t think I’d go back to skiing those skis even if I could, I don’t miss having all that tip out in front of me in anything but the firmest snow.

I'm having a particular bad stretch of back pain lately, like debilitating to normal life. Has anyone ever had pain in their testicles associated with back pain? Seems worrisome, but I could see a compressed nerve causing it. Doc on Monday and I'm going to push for an MRI.

Its usually core issues IME

I was having some issues and I told the young female PT that when I had tightened my scrotum up into my body, something crunched and my back is feeling pretty good since then

she remained quite proffesional and said " ah yes we call that raising the pelvic floor "

I do not think I would have the restraint abide by these recommendations.

ZZZ - One of the nerves in your lower back wraps around the outside of the hip and down into the groin. A pinch or more chronic damage can create this pain. Kinda dull, maybe a throb that hurts more and even a sharper pain sometimes. More frequent urination too.

A direct hit to my tailbone in '93 left me with a lifer of pain from there and once, about 3 years ago had to get it diagnosed. I eat a big ole anti-inflamm for it now and haven't had a recurrence down there since.
If you don't have a history and tweaked it with the flagstones, maybe a chiro tweak or a mega- massge therapy sesh would help.

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Originally Posted by FortySixMac

I do not think I would have the restraint abide by these recommendations.

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Oh RLY?!? It takes restraint to engage in raising he pelvic floor/scrotum tightening??? I sense a lack of training in fine tuning/control. Time to up your game - your sex partners will thank you.

Chiro that specializes in ART can help with nerve pain. The whole practice is predicated on releasing pressure on irritated nerves. Worked for me in a couple instances.

I feel like I might as well piss straight into the wind when I say this cause not a single person who came on here with back pain looking for advice has ever listened, but here I go again:

St. John's Wort oil, if applied daily on the spine every day for a year will fix herniated, bulging, and ruptured discs, and miscellaneous spinal issues. I hate to even say that I've broken my back four times and clawed my way back from partial paralysis, but that's why the fuck I know it works. For twenty years my back hurt. And it's been much better the last twenty years since I did it. I've seen all the images throughout the journey of my back ordeals and the difference is astounding. But I already knew that. After all the hits, breaks, bulging discs, and vertebrae that had worn into a c shape, my last full spine x ray taken a year ago looked damn near normal. I can't believe nobody has tried this. Better to go get cut, I guess. Maybe. I don't know. I've never had my back cut into.

That's the first I'd heard of using that and I will be giving it a go.
Can ya give me a few more details on the best approach?

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Originally Posted by Djongo Unchained

That's the first I'd heard of using that and I will be giving it a go.
Can ya give me a few more details on the best approach?

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It’s best to have a caring naked woman apply it for you


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What he said. Have her rub it gently around the injured area and up and down the full length of your spine. This is what smart people did before morphine and vicodin. Smear some of my cbd cream on it to let the dmso deliver in even further and I bet it will magnify the healing effect. I might have made my cbd cream to help with pain, but healing my broke stuff was on my mind much more than just pain relief. I've been into natural healing since I was in my 20's.

But there's a catch - you have to do it every day for a year.
If you can do that, you'll get to enjoy the healing effect that will make a life difference.

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Originally Posted by zion zig zag

I'm having a particular bad stretch of back pain lately, like debilitating to normal life. Has anyone ever had pain in their testicles associated with back pain? Seems worrisome, but I could see a compressed nerve causing it. Doc on Monday and I'm going to push for an MRI.

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Yes, same thing here. Could be nerve issues, disc compression problems and even prostate problems.


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Quote:

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Originally Posted by zion zig zag

I'm having a particular bad stretch of back pain lately, like debilitating to normal life. Has anyone ever had pain in their testicles associated with back pain? Seems worrisome, but I could see a compressed nerve causing it. Doc on Monday and I'm going to push for an MRI.

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You should check out Kevin Meehan. He's kind of a kooky guy, but that guy has this acupuncture, chiro, massage combo therapy which is the only thing I've gotten in Jackson that made any sort of difference.