Reduced space btwn L4-L5...

Injury Clinic
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One player I worked with just did a magnetic resonance imaging of his lower back, and the docs told him that the space between L4-L5 is reduced and that the vertebrae are pinching nerves.

He has symptoms of pain that limits his hip flexion when the leg is straight (normal when flexed), and the pain is experienced in the hip (somewhere near piriformis) and down the leg over the ITB and finishing on the caput fibulae.

Other docs said it is his hip that is the problem, and now they say it is his spine… they even stated that he will never be able to play basket again (which is a dumb statement, since he plays it ‘normally’).

He is 17 y.o…

The sysmptoms are from january, when we did strength training and he also did some strength training at his club. He told me that he did dead lift there (I avoided doing it, sice he lacked technique and rom) and since then he got spine/hip issues. We totally reduced weight on the squat, he was unable to do RDLs, we mostly did bench, chins and rows.

I wonder how can I help him?

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I guess you need to let him rest and certainly avoid anything which compresses the spine. Has he seen an osteopath? Did he feel anything accute when it first became an issue? Like his back clicking or popping? Could be in need of manipulation. I am no expert at all, but that’s my two cents.

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Did the MRI reveal a herniated disc? What treatment has he received so far?

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Find a doctor that do neuraltherapy/mesotherapy, your athlete need segmental therapy and ozono therapy.
Then, soft tissue work, decoaptation as ELDOA and chiro work.

You can help him with basic trigger/tender point work.
A word of caution on stretching, sometimes in this situation can aggravate the symptom.

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From what I have read, things of this nature are very common with basketball players. They’re spines are constantly absorbing the forces of jumping.

Also, they wear horrible shoes which causes force absorption to take places in different proportions than it normally would.

Basketball players are also known to be slackers in the weight room so they do not enjoy any of those benefits.

I happen to believe a lot of their problems are rooted firstly in their footwear and then this causes a chain reaction. Very few basketball players are able to do things such as squat fully or do other exercises with a full ROM (leg exercises) due to things such as horrible ankle mobility (from shoes), knee pain (from shoes), poor hip mobility (from shoes) etc. All these things cause their backs to take on work it would normally not have causing excessive compression and various problems, especially in the lumbar area where compression is most due to lordosis.

Therefore, try to deload the spine a great deal. There’s a lot of ways to do this but I highly advise just having the athlete sit in a squat position a few times a day for a decent amount of time rather than do things such as sitting in a chair (chair=even more compression).

I love this article, especially the squatting portion

http://www.easyvigour.net.nz/fitness/h_gluteus_maxintro.htm

This will help the athlete get mobile ankles again, promote stability in the knee, deload the spine, stretch the spinal erectors which I bet are tight as hell if there is all this compression going on, as well as activate the psoas (only hip flexor that is primarily active above 90 degrees of hip flexion) and activate the glutes. All of this will help take pressure and workload off the lower back hopefully help the back feel better in the long run.

I had on and off back pain/excessive tightness in my lumbar area for the longest time and simply sitting in a squat position throughout the day rather than sitting in a chair, basically living the way the human body was intended, has helped my lower back tremendously. If your athlete is tall, which I myself am, this might be a pain in the ass as being well over 6 foot causes a much longer way down into a squat than those who are less than 6 foot but it is worth it.

Lastly, preach the importance of foot wear and the impact it can have. Wearing cinder block shoes with huge heel lifts just makes the lower back absorb even more force.

I really think this will help and hope it does.

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A good manual therapist will be needed to relieve the tension and ease the compression … stretching is near impossible and exercises are very tricky apart from a little core work that doesn’t aggravate psoas … Chiro possibly - but I’d prefer a manual therpaist

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Maris, Robin,
I’ll see the results in a day or two and post it here. He felt ‘something’ when doing deadlift… I guess his disk is not herniated it is ‘reduced’ (like with old people). We are avoiding all spine compressing exercises. He received electro-therapy for the hip (mis-diagnosis by chiro?) and now is receiving electro therapy of the back. Will know more when I see him and take a look at the results of MRI.

Jamirok,
Hard to find a decent expert here… I can show him ELDOA stuff and do the trigger-point, but for other stuff I’m not sure. Maybe I could come to Ita and learn :slight_smile: I would be interested :slight_smile:

Desideratus,
Thanks for your input. You hae actually guessed well about his erector spinae (very stiff). I’ll read the article you posted (thanks). What do others think about desideratus opinion???

Thank you for the support guys!

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Can you release psoas for them?

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Certainly ELDOA will be important if you can find someone who knows how to do these!

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Hmmmm… no one… I got a book and ‘manual’ by Flash…

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Yes, but some yoga asanas are similar to eldoa positions, ok I’ll say yoga :stuck_out_tongue:

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Yes, but ELDOA can be replaced from some YOGA asanas, or you can do classic (with caution) “inversion therapy”.

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TopCat,
It is ‘Permanent Pain Cure’ book by Ming Chew. I sterted reading it, great BS stuff and ming Method Propaganda, but I guess there will be some info on ELDOA.

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Not knowing much about ELDOA I checked out the site and these are the proposed benefits:

"The benefits include:

Reduced vertebral compression
Improved circulation
Spinal disc re-hydration
Increased muscle tone and awareness"

In terms of disc rehydration, this takes place every night you sleep. So if someone, duxx say your athlete, is sleeping for 8 hours a night and he isn’t sleeping on his stomach (you might want to confirm this as sleeping on your stomach puts the lumbar spine in a compressed position!) then his discs are already filling up with fluid for 8 hours a day! Therefore, is a stretching routine necessary for this?

Being an athlete, I would doubt increasing muscle tone and awareness would be a concern but it could be possible.

Improved circulation? Go for a walk.

Anyways my point is, I highly doubt you need some elaborate stretching routine. Humans have evolved over all these years with their spines not needing stretching, so why do we need it now? We think we need it because our spines are constantly compressed all day due to inventions such as chairs and couches. Third world countries who aren’t fortunate (debateable) to have chairs and such don’t experience back pain. They already experience an optimal length tension relationship in their back due to when they stand they experience compression, and when they sit (squat for them!) and sleep: decompression. Sitting (squatting) and sleeping takes care of all their and what should be our spine stretching needs.

Function the way your body was intended and your body will function the way you want.

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And also, I noticed on the ELDOA page that, not surprisingly as is the case with yoga, the hamstrings are a focus of stretching as well.

If someone’s spinal erectors are tight, stretching the hamstrings is 100% contraindicated.

Short spinal erectors = long hamstrings. So why would you lengthen the hamstrings even FURTHER to alleviate short spinal erectors???

I forgot to mention (sorry to belabor the point though) that this is also a benefit of squatting to sit such as in the bushman article I posted earlier. The hamstrings are stressed in a shortened position thus helping to, if needed, tighten them up a bit (causing a chain reaction of loosening up, if needed, the spinal erectors). Once again, your body, if used as intended, already has optimal length tension relationships in place. Hamstrings length standing up =neutral or probably lengthened a bit (but not to the degree to cause a tight back!) but hamstrings squatting = tight. In the end this generally results in optimal.