Lumbar Microdiscectomy Surgery for Herniated Disk

[headtrainer]

I agree that walking is one of the most important exercises for spine and what you should do if you cannot do anything else. I often ask the doctors and PTs I work with what would be there #1 exercise to recommend to any patient with a spine issue and I get various answers. But my answer was always walking and slow marching. But to disregard both straight leg raises and kick backs makes no senes. If you cannot do either or find benefit from either then you have some sort of dysfunction somewhere along the line allowing for these to effect you negatively. I look at it as if the dysfunction is the issue and not the exercise.

Straight leg raises puts you in a position where the ab muscles can’t serve as a mover until the pelvis moves posteriorly. Therefore, leg lifts are a (contraindicated) hip flexor exercise that places a lot of strain on the structures of the spine—causing back pain to get worse.

 

[headtrainer]

I agree that walking is one of the most important exercises for spine and what you should do if you cannot do anything else. I often ask the doctors and PTs I work with what would be there #1 exercise to recommend to any patient with a spine issue and I get various answers. But my answer was always walking and slow marching. But to disregard both straight leg raises and kick backs makes no senes. If you cannot do either or find benefit from either then you have some sort of dysfunction somewhere along the line allowing for these to effect you negatively. I look at it as if the dysfunction is the issue and not the exercise.

Marching will usually increase lower back pain if you have a herniated disc or bad arthritis. In regards to kickbacks for someone with lower back pain they are often told to “use their glutes, and not their back” or to “strengthen their glutes”. That statement is true. Unfortunately, building the glutes will usually increase back/leg pain for those with a herniated disc. Especially when twisting is involved or the exercise is performed on the knees like glute kick backs.

 

[headtrainer]

I agree that walking is one of the most important exercises for spine and what you should do if you cannot do anything else. I often ask the doctors and PTs I work with what would be there #1 exercise to recommend to any patient with a spine issue and I get various answers. But my answer was always walking and slow marching. But to disregard both straight leg raises and kick backs makes no senes. If you cannot do either or find benefit from either then you have some sort of dysfunction somewhere along the line allowing for these to effect you negatively. I look at it as if the dysfunction is the issue and not the exercise.

A common misconception for people with a herniated disc/discs is that if a “flare up” (increased burning or muscular fatigue) is felt in the lower back during a glute or leg exercise, this is an indication that the back or core is “weak.” In reality, it’s the sciatic nerve being pinched during the exercise.

 

[Bio]

I now have arachnoiditis in my l-5/s1 are from past surges causing scar tissue build up. It makes training legs a challenge, and then some. I hope you don’t develop it.

I'm sorry to hear that HT, it sounds awful. I'll look into to it .

 

[TrippplePPP]

How many back surgeries have you had?

Zero. Not sure if you are honestly asking or if you are trying to ask why I seem to be contradicting you with confidence? I have worked in medical field since college and past 17 years with spine physicians (physiatrists, pain management, anesthesia), surgeons, physical therapist, chiropractors at a Spine center and now work with ortho surgeons along with more spine surgeons. I have worked with some pretty bright and talented people over the years. I also have lifted like crazy since a young age and developed a spine issue in which I have treated with diet, exercise, fasting and a whole lot of question seeking and finding answers through these avenues and other. I avoided medications and surgery with success.

Straight leg raises puts you in a position where the ab muscles can’t serve as a mover until the pelvis moves posteriorly. Therefore, leg lifts are a (contraindicated) hip flexor exercise that places a lot of strain on the structures of the spine—causing back pain to get worse.

Again, disagree. You have a dysfunction if leg raises increase your back pain. Yes, the illiopsoas and illiacus can compress your spine if they are tight along with pulling you vertebrae anteriorly yet if you have balanced strength with all surrounding stabilizers (glutei, lower abdomen, etc) along with adequately lengthened hip flexors then this should not be concern. If your pelvis is moving posteriorly then you glutes are weak and so is your lower abb.

Marching will usually increase lower back pain if you have a herniated disc or bad arthritis. In regards to kickbacks for someone with lower back pain they are often told to “use their glutes, and not their back” or to “strengthen their glutes”. That statement is true. Unfortunately, building the glutes will usually increase back/leg pain for those with a herniated disc. Especially when twisting is involved or the exercise is performed on the knees like glute kick backs.

Marching will increase low back pain if your glutes are weak, especially minimus and medius along with TFL. Marching is a great exercise for spine. Many elderly people do this frequently with success.

Glute kick backs need a properly strengthened core. A person should be able to isometrically control their abdomen and core prior to doing a dynamic movement involving extending the hip. Yes, if the core, low back and abs are weak then the kick but would be applying too much force for the core to control. So the idea would be to strengthen core prior to stabilize and absorb this force then progress to the kickback motion.

A common misconception for people with a herniated disc/discs is that if a “flare up” (increased burning or muscular fatigue) is felt in the lower back during a glute or leg exercise, this is an indication that the back or core is “weak.” In reality, it’s the sciatic nerve being pinched during the exercise.

Back pain with exercise does not equal "sciatic" nerve being pinched. There are plenty of reasons a person can have back pain during exercise without the sciatic nerve being effected. A great percentage of people have herniated and bulging discs and never know it. Often people get MRIs and have several levels with degeneration yet not all of it contributes to their pain.

 

[headtrainer]

Zero. Not sure if you are honestly asking or if you are trying to ask why I seem to be contradicting you with confidence? I have worked in medical field since college and past 17 years with spine physicians (physiatrists, pain management, anesthesia), surgeons, physical therapist, chiropractors at a Spine center and now work with ortho surgeons along with more spine surgeons. I have worked with some pretty bright and talented people over the years. I also have lifted like crazy since a young age and developed a spine issue in which I have treated with diet, exercise, fasting and a whole lot of question seeking and finding answers through these avenues and other. I avoided medications and surgery with success.



Again, disagree. You have a dysfunction if leg raises increase your back pain. Yes, the illiopsoas and illiacus can compress your spine if they are tight along with pulling you vertebrae anteriorly yet if you have balanced strength with all surrounding stabilizers (glutei, lower abdomen, etc) along with adequately lengthened hip flexors then this should not be concern. If your pelvis is moving posteriorly then you glutes are weak and so is your lower abb.

Marching will increase low back pain if your glutes are weak, especially minimus and medius along with TFL. Marching is a great exercise for spine. Many elderly people do this frequently with success.

Glute kick backs need a properly strengthened core. A person should be able to isometrically control their abdomen and core prior to doing a dynamic movement involving extending the hip. Yes, if the core, low back and abs are weak then the kick but would be applying too much force for the core to control. So the idea would be to strengthen core prior to stabilize and absorb this force then progress to the kickback motion.


Back pain with exercise does not equal "sciatic" nerve being pinched. There are plenty of reasons a person can have back pain during exercise without the sciatic nerve being effected. A great percentage of people have herniated and bulging discs and never know it. Often people get MRIs and have several levels with degeneration yet not all of it contributes to their pain.

I thought you had had a previous back surgery/surgeries. Therefore, I was going to say if you just had a one level laminectomy you can’t compare that to a multiple level fusion because the fusion creates a DYSFUNCTION in the back. So does a herniated disc, bone spurs and scar tissue—from previous surgeries. Those are the people who will usually experience more pain with leg lifts. Like you said, a DYSFUNCTIONAL structure in the back can cause an increase in pain. Those who just have muscular issues can sometimes benefit from the same exercises that makes those with a DYSFUNCTION hurt. I have a significant DYSFUNCTION in my back. So I am speaking from experience. When I went to rehab the physical therapists said they felt like they should be paying me because I taught them things that can’t be learned from a text book. Managing back pain could be compared to bodybuilding in the sense that learning how to properly build your best body by reading a book is much different than actually doing it in real life. I’m glad your back is doing well.

 

[TrippplePPP]

I thought you had had a previous back surgery/surgeries. Therefore, I was going to say if you just had a one level laminectomy you can’t compare that to a multiple level fusion because the fusion creates a DYSFUNCTION in the back. So does a herniated disc, bone spurs and scar tissue—from previous surgeries. Those are the people who will usually experience more pain with leg lifts. Like you said, a DYSFUNCTIONAL structure in the back can cause an increase in pain. Those who just have muscular issues can sometimes benefit from the same exercises that makes those with a DYSFUNCTION hurt. I have a significant DYSFUNCTION in my back. So I am speaking from experience. When I went to rehab the physical therapists said they felt like they should be paying me because I taught them things that can’t be learned from a text book. Managing back pain could be compared to bodybuilding in the sense that learning how to properly build your best body by reading a book is much different than actually doing it in real life. I’m glad your back is doing well.

There are definitely many ways to skin a cat and I don't know everything. Also debating with other helps me learn. I can be opinionated with spine as I worked in it for so long and have had issues myself. But you are right I cannot speak from experience like you in that regard. And you know what, working with docs and PTs with same degree they also all go about it in their own unique way in which can contrast each others beliefs yet each one can be equally successful with treatment. I always say its like two carpenters building two awesome houses using slightly different tools yet creating equally appealing houses. Thanks for debating with me and the kind words. And hope you spine holds up too.