When it comes to getting back into working out with a disc bulge, knowing what not to do is often just as important as anything else. However, as much as we would like a simple checklist of exercises to avoid if you have a lumbar disc bulge, it is not that easy. You see, some exercises are not advised at certain times in the recovery process and others have little value to your rehabilitation at all. In other instances there are exercises that are relevant to your earlier recovery and these will change as the disc bulge or herniation heals over time. This week we’ll work to help you better understand the pathway forwards if you’ve been struggling with a lower back disc bulge, whether a minor injury or full blown L5, S1 disc herniation.
Weak low back discs that are easily damaged
Fundamentally your lower back discs are as weak or as strong as you want to make them, on the one hand we have those who are extremely vulnerable, one wrong move or quick turn can spell disaster, for others, they are able to bear tremendous load with world class powerlifters and strongmen lifting hundreds of pounds of weight on their back without trouble, regularly. Both are examples of human beings just like you or me, both have honed the ability their lower back has, either more purposefully or without conscious intent.
You see, if you have a weak lower back and are worried about your discs, this is such an important concept to grasp. There is certainly hope ahead for you, if you follow these lessons. The human body is marvelous and will respond to how you use it, bone density, ligament strength, muscle strength, spinal disc health and resilience, these things are all dynamic and your body is constantly working to adapt itself in an intelligent way. There are some scenarios where our bodies can let us down, and where a little help from modern medicine can come in handy, for example, the hormone changes during menopause in women can adversely affect bone density. However, if we are switched on and proactive, with support this can be more of a road bump than anything more severe.
Your disc health however, is almost entirely at your mercy. Whether or not it has been injured in the past, there is one way to improve the health of the spine in general and encourage healing and regeneration. Ultimately to restore your back health. If you do this right then the notion of having a weak lower back is something you can completely dismiss for the long term!
Injuring the lower back discs: disc bulges and disc herniations
An injury at the end of the day is just that, it is damage to the tissues, whether this strain to the annulus fibrosus of the L4, L5 disc results in a minor disc bulge or more severe herniation, we must acknowledge that damage has taken place. When damage takes place, performance is impaired, this is an inescapable fact.
With this weakness we have a certain set of strategies to help the first role of healing. To protect the area to be resilient to the basic stresses that are placed on the lower back during daily life. Once momentum has gathered here, we can start a more long term focus of restoring strength and resilience to the local area, the spinal segment, including the disc, and the spine at large.
The only way to rebuild damaged discs in your low back
When it comes to rebuilding damaged discs in your lower back the only way to do this is through load bearing resistance exercises which we will get to later, however doing so at the wrong time will be detrimental for you and would run the risk of making things decidedly worse. If you’re to have success with healing the discs in your lower back then this framework is going to be essential. We’ll break things down to different phases of the healing process to help you understand how changing dynamics result in different approaches through this process.
Exercises to avoid when you’ve got a low back disc bulge
When you first injure your lower back, the load of daily life is often a problem. Just being weight bearing itself can be a real challenge, possibly giving you severe low back pain and sometimes sciatic pain down the leg too.
Avoid load to your spine that will compress your disc
In this early stage you should avoid carrying extra load, lifting and the like will not be helpful. When there is an active flare up or injury that means even load bearing is problematic, you want to do your best to avoid unnecessary load. Often most of these examples will not be exercises, you’ll get caught violating this lesson when you pick up the laundry, carry the shopping or pick up your young child. Do your best to avoid these things for a short period, often not a tremendous amount of time necessarily, but we will talk about this more later on in your recovery journey.
Avoid mobilisation or movement exercises for your disc
These exercises include movements like knee rocks, or worse, knee hugs and child’s pose. These exercises or movements are simply wiggling the area that is injured, and with unnecessary amplitude. Amplitude in this example is the range of motion, how much the spine is moved. If we take knee hugs and knee rocks, we are moving the back a significant amount, and therefore rotating or bending the lumbar spine and the injured disc a lot! This amount of movement is unhelpful and why so many find they just go round in circles doing these exercises with no results, sometimes for months or even years. You’re preventing the healing process from taking place effectively.
Avoid unnecessary load bearing exercises
For some who’ve just injured their lower back disc, especially the first few times, they might be tempted to “strengthen” right away, and will result in loading the spine and making things worse! There is a time for load to be added but this is not it!
Avoid extended bed rest if you’ve herniated your lower back disc
This is probably one of the worst things you can do, primarily because the lower back is supported and protected by the lumbar and core musculature as well as the muscles of the legs. Extended bed rest is going to result in significant reductions in strength and integrity of these vital muscles. Although you might feel better as you give yourself an opportunity for healing, the resilience of your low back will decline dramatically, resulting in you being significantly more vulnerable on the other side of the bed rest. This is a trap that some fall into and find they need a lot of support to get out of pain afterwards. Avoid this at all costs.
What you should do when you first injure your lower back discs
In short, taking some load off the lower back is helpful, for example, the best stretch for your lower back disc health is the lumbar towel exercise. Additionally some correct stretching to keep your hips mobile will reduce the pressure on your lower back disc, provided you do this correctly, we covered some specific examples in the episode on herniated disc stretches which detailed how you should be doing specific stretches and exercises when recovering from herniated discs. Combined with “when you should do them” in this article you should feel more confident moving forwards. In addition to this your focus should be on off weight bearing exercises that help you learn how to use your core muscles to control for erroneous spinal movement.
This is essential.
Without control over your spinal stability, and an ability to stop it moving when forces act on your body, you will not have the ability to properly protect your lower back disc as it recovers and all other exercises will fundamentally be bad. Or more accurately, you will do other exercises incorrectly as you lack the foundations. Some exercises that will help you do this include:
- Core-set engagement
- Psoas engagement
- Modified deadbug
- Marching bridge
The way you do these exercises is important so make sure you avoid the common mistake, to pelvic tuck when you engage your core. This is something we talk a lot about in the Back In Shape Program as we help members build the right foundation. Often we find that even though most have been taught similar versions of these exercises, the detail makes a huge difference to the effectiveness!
Mistakes to avoid as your disc bulge is recovering
As you master control of your spine stability, you’ll find that you can manage the aggravation of your lower back pain or sciatica more competently. You start to feel that healing is taking place and perhaps have the ability to control your back when you feel you’ve perhaps walked too much or are moving poorly. A quick core engagement and posture check can often alleviate a good amount of discomfort.
Avoid doing other activities instead of proper exercises
Often at this stage, you’ll be doing daily activities, albeit with pain to a greater or lesser degree. People too often focus on the fact that they cannot do “exercises here” such as the squat or hip hinge which we will get to shortly. Instead they will be getting in and out of chairs and doing all sorts of things on a daily basis which are much worse than regimented and purposeful exercises.
This is one of the most frustrating situations, as there have been so many occasions over the years, speaking to people who recoil at the idea of doing bodyweight squats for example, yet are doing a myriad of daily activities on a daily basis in spite of the pain. As you have learned the skills in the earlier section, these must be applied to the exercises you are doing as well as the daily activities.
When you’re doing activities like getting out of chairs, in and out of the car, chasing after a toddler or other “daily life tasks” you often do not focus the same way as doing a regimented exercise and this is such a source of daily aggravation.
Avoid lifting and carrying at this stage of your disc recovery
The most important thing you must do at this stage of recovery for your disc is learn to move correctly upright, the core control exercises in the previous section are great and very safe, but you must now incorporate those into the real world with upright bodyweight movements that will test your ability to move without overtly straining the injured disc. At this point there will still be vulnerability in your lower back. If you move too far or in a way where you do not have control, movement will leak into the weak link in your lower back, the segment with the disc bulge. Therefore building solid movement patterns in these three fundamental movements is vital to all of us. There is no one who is exempt from this requirement.
Focus on these 3 foundational movements
As you feel confident you’re able to do some simple variation of the core exercises mentioned above you must move to upright and work on our 3 favorite movements. The squat, lunge and hip hinge. You will not go through a day in your life without doing at least 2 out of the three of these exercises in some form. However from experience clinically and with our members in recent years, these exercises should not be taken for granted.
Even in my experience as a public gym user, many individuals struggle to do these movements with good form, let alone if you have a lower back disc injury – you cannot afford to get it wrong!
We have guidance and dedicated episodes of the podcast on these specific exercises as well as detailed instruction, education and variations in the program if you need more instruction.
Your goal here should be to be able to perform these exercises with competent form, to a reasonable depth and without your knees, ankles, hips or back moving in ways which will result in injury. This is often where we discover other joints are not as healthy, strong or resilient as they should be too.
The two biggest mistakes those with a disc bulge make
These two exercise mistakes are the biggest source of relapse in those with disc herniations, so you must avoid these at all costs, they do not come down to technique or ability, they are very simply mind-set and academic understanding. It’s not complex, it’s actually remarkably simple!
Avoid lifting weights if you have a disc bulge in your lower back
It is only through adding weight, load or resistance to the three movements mentioned above that you can rebuild your back. A common belief is that this is not required or not appropriate for you.
This is wrong.
Granted you should avoid the weights in the earlier stages, but if you have gone through the previous steps properly, you’re ready to add weights or resistance to load the spine. It is through this gradual increase in the load on the aforementioned movements that you train your body to control and manage movement at a higher level. The managed load additionally provides the stimulation for the discs to know how to rebuild themselves and how far this process should go. Failure to do this leaves you vulnerable.
It is like having a suit of metal armor. And instead of replacing the damaged metal chest plate with metal, you used leather. Sure it is replaced and it might protect from some minor assault, but the moment it is subject to forces beyond a rudimentary level, you will very quickly realise it is not metal.
Your back will heal but it is this strengthening process that is what builds your resilience. It matters little what age you might be or your particular circumstances, you should have some baseline that you build back to. We like the use of real world examples to evaluate “how much weight do you need”. For this we look at things like holiday suitcases, 20-25kg, or children and grandchildren that are likely to want to be picked up 15 to 30kg. Or perhaps you have a dog, that dog, when on the lead could pull, which might be significantly more in load.
The simple goal is to make sure that your loads on these exercises are significantly greater than those loads which your back might be exposed to in everyday life.
Avoid the mistake of stopping too soon
The second mistake people make is the assumption that they can stop resistance training and rehabilitation just because the pain has gone away. It is less common that this is a decision that’s consciously made. Instead it is more likely that the motivation to continue on with the exercises simply disappears. This is because pain, the great motivator, is no longer present. Sometimes it is simply that the person feels there is no longer a need to continue further, this is rarely based on an objective evaluation of the status quo.
The role of strengthening comes into its own, often after the pain has gone. It is when the impediment of pain is removed that you can continue to utilise strength training work to provide the stimulation for your injured discs and surrounding protective tissues to build their resilience.
Avoid scaling resistances and weights too fast in the gym
One of the realities of disc bulges is that they heal much more slowly than other tissues. Those of you that enjoy working out at home or in the gym can often fall into the trap of increasing the load on the spine too fast. This is often a source of flare ups.
We mentioned load being added is really important but the rate at which your thigh, hip, back and core muscles will adapt to this new strain is much greater than the spine and your discs. Incorporating the knowledge into your plan going forwards is a must. Doing so will steer you clear of the common error of going too far too soon.
Strategies for recovery from a lower lumbar disc bulge
Ultimately it comes down to a relatively simple step by step process to recover effectively from a disc bulge. Remove unnecessary stretches and movements that deviate from this step by step plan and then follow the below strategy.
Begin with spine control
Focus to begin with on off-weight bearing spinal control exercises to build the awareness of how to brace and protect the lumbar spine and by extension the disc that is injured.
Develop bodyweight control with real movements
Using simple real-to-life movements such as the squat and hip hinges. You can start out building good load bearing techniques with these movements. You’re doing them every day regardless of the pain you’re in so you should prioritise learning to do them correctly.
Begin to safely add resistance, load or weights
Once correct technique with these exercises is developed, you should begin to add resistances through bands or weights so that you can progress the healing and remodeling process.
Scale the resistances long term for maximum spinal resilience
From here, work on building the resistances you’re using over time. Make sure that you have the necessary checks and balances as far as form is concerned to ensure you continue to work out correctly and that technical errors do not creep in and derail your progress.
If you feel like you could benefit from a step by step plan complete with exercises, workouts, education and the support along the way, then check out the Back In Shape Program. Membership gives you everything you need to properly recover from a lower back disc injury and return to normal life!