Bulged Disc? Don’t Panic.

Bulged discs are also known as “herniated”, “prolapsed” , “ruptured”, “slipped” or “protruding”.  I have intimate experience with this type of injury (see my post about the incident).   Here’s a dose of science to help you understand the problem and how to recover.

Disclaimer: I am not a doctor and I do not attempt to give medical advice.  I don’t trust most doctors, and I hope you will take the time to find a good doctor if you think you have a serious back problem.

The Fear that Comes with this Injury

I won’t lie.  This injury really, and I mean really, sucks.  It sucks because the pain can be debilitating, but worse, it sucks because of the fear it causes.  This type of pain can be so severe that no position offers relief and recovery seems impossible.  In severe cases, the back or neck feel like they are so seriously injured that something must be torn or broken.  Often, victims can’t walk or sit properly.  It’s horrifying.  When in such intense pain, patients are vulnerable.  We are easily convinced to turn to the wrong treatments.  We want instant relief.  We want answers.  Most doctors are too quick to say the S word (surgery).  These doctors should be avoided and second opinions should be sought.  Most doctors are also too quick to prescribe pain medication, which in my opinion is a poor choice for this injury.  I have overcome disc bulges 3 times and now I am back to doing heavy squats and dead lifts again at the age of 40.  When I didn’t understand what was happening to me, I made a shitload of mistakes that set me back in the healing process.  Please learn from my mistakes.

What is a Bulged Disk?

Between each of the vertebrae in the spinal column lie discs that act as shock absorbers for the spine.  The discs allow for slight movement of the vertebrae and also act as ligaments to hold the vertebrae in place.  The discs consist of an outer fibrous ring (annulus fibrosus) and an inner softer nucleus (nucleus
pulposus). If there is dysfunction in spinal movement, usually due to poor posture or limited mobility in nearby spinal regions, then these fibrocartilaginous joints receive pressure beyond their design range.

Under such pressure, the outermost layers of the annulus fibrosus become deformed, bulging out of their normal shape.   In extreme cases, a disc bulge or disc protrusion may progress to a spinal disc herniation, in which a tear in the outer fibrous ring of the disc allows the softer inner material to bulge out beyond the damaged outer rings.  An MRI is the only way to know for certain whether the outer rings are torn.  However, the outer rings only tear in extreme cases.  Do not panic.  Stay off the internet.  It’s full of BS that will only freak you out.

What Behaviors Causes a Disc to Bulge?

Athletes often think disc problems are the direct result of their sports or workouts.  Not so.  The reality is that disc injury is always cumulative.  This means that there is always a chain of events that leads up to an acute episode.  The chain of events often looks like this:

• Poor posture when sitting (working at a desk, driving, on airplanes, or relaxing).
• Poor posture AFTER your workout. Strenuous workouts leave the spine in a hyper mobile state.  Therefore it is important to maintain good posture in the hours following a workout.
• Bad form in performing routine motions around the house.  Think you only need good form in the gym?  Think again.  Most disc injuries happen doing something silly like picking up a bag of groceries.
  

  This is spinal extension, the best position to help a disc heal.

How Do I Know if I Have a Disc Bulge?

It’s impossible to be certain without an MRI.  Don’t want to pay for one?  Here are a few telltale signs.

• the pain is worst when you get out of bed in the morning
• the pain decreases after doing spinal extension exercises
• the pain increases when in spinal flexion

The bulged disc perception paradox.

Often, the onset of a disc bulge is gradual and can feel like tightness in the lower back.  As the disc begins to bulge, the lumbar muscles will often spasm as a self protective measure.  In this case, it is best to obey the pain.  This perceived tightness often leads athletes to stretch the lower back muscles, which is exactly what they should NOT be doing.  Flexing the spine should be avoided AT ALL COSTS.  Instead, spinal extension exercises should be performed.  Lordosis should be maintained at all times while the injury is in the acute stage.

Recovery: How to Heal Quickly from a Disc Bulge

• Maintain Perfect Posture at all times while healing!
• Do spinal extension exercises every hour
• Do not load the spine with heavy weight such as with squats or deadlifts
• Stay hydrated
• Obey the pain.  Don’t work through it.
• Do the recommended reading at the end of this post

 

 

Learn from my mistakes

Big Mistake 1: Do not a stretch the wrong way.  I perceived tightness in the lower back as a need to stretch the lower back muscles (in spinal flexion). I could not have been more wrong. The paradox of the bulged disc is that I interpreted the tightness as my body telling me I needed to stretch a tight muscle. In this case, the muscles were in spasm as a protection mechanism. What my body was really saying is “slow the fuck down, this is serious, you need to heal”. Instead of listening, I stretched, and stretched, bulging the disc further and further. I should have been doing McKenzie exercises instead.) TK link

Big Mistake 2: Do not squat or dead lift if your back hurts. My squat addiction not only slowed the healing of my disc, but also made it worse. I perceived a mild low back injury (minor bulge) as something I needed to “work through” and “tough out”. I kept on loading up the plates when my back was sore, thinking what I needed was a good workout to loosen up. Bad idea. I could have healed in a few weeks. Instead I blew the disc out further and had to lay off squats for months.

No Squats or Dead Lifts until you’re 100% (Don’t Worry, You can Still Train Legs)

Heavy squats and dead lifts are an essential part of my training regimen. In the past I always loathed leg day, but over the years, I have come to realize that squats give me the best performance boost to my work life.  The improved mental clarity, increased testosterone, and higher endorphin release are all best on leg day. Now I coordinate important meetings and high stress tasks to fall on my leg days, so I can be at peak mental performance.  Since I have come to use squats like a drug to simultaneously calm my anxiety and ramp up my mental focus, I panicked when I bulged a lumbar disc last October.  What will I do for anxiety?  How will I keep my legs strong?

Here are 3 great leg exercises that will not set you back in healing time.

• Split Squats
• Goblet squats
• Walking lunges

Remember to use extreme caution when picking up dumbbells in the gym.  Maintain lordosis at all times! One false move picking up a dumbbell and you will set yourself back another week.  Move with caution!

How to Know when it’s okay to go into spinal flexion

• Pay special attention to how you feel when you take the first few steps out of bed in the morning.  If you have pain, then you are not healed and you should not allow your spine to go out of a state of lordosis.  When you have no pain, you can gradually begin to work back into spinal flexion.

How to prevent relapse of a bulged disc.

• Maintain Proper Posture at all times.  (In the gym, in the car, on the plane, on the couch, everywhere.)
• Make sure your mid thoracic mobility is up to par.  Most people are hyper mobile in the lumbar spine and too rigid in the thoracic spine.  Learn some thoracic mobility exercises. (TK link)
• Do the Three Miracle Stretches for Low Back Pain

Recommended Reading for a bulged disc.

If you are serious about healing quickly, buy this book:

7 steps to a Pain Free Life, by Robin McKenzie

If you are serious about protecting your back, check out my personal coach, who has an entire program designed for athletes with back issues.

Rob Jones