Lower Back Injury

I had a similar injury in high school/first year of college. Overextended my back doing 200's and felt something shift. It ended up being a bulging disc in my lower spine (god knows how that happened) and I had pain for about a year.

Your symptoms sound a little more like a muscle issue. If you had a disc problem then touching your toes would likely aggravate it as well as any flexion of the back. Disc pain (actually it's nerve pain the disc is pushing on) is kinda hard to explain and pin point and the area of perceived pain can change over time. If it's a muscle issue then direct palpation of the area will hurt. This won't happen if its a spine problem. Muscle issues shouldn't last too long. If it's a disc issue you need help asap. Leaving it alone is a very bad idea.

Well, I saw my primary care physician. He checked my reflexes and ruled out disc issues since appeared to be fine.

Talking with a friend who is going into surgery next week said 'his legs were on fire'. Since my legs feel fine, I'm ruling out the disc issue.

I'm guessing a moderate muscle strain.

Hoping it is not a sprain (as those apparently take longer to heal).

Thanks for the response.

Could be something with your hip flexors?

Do you just have sharp pain or do you get muscle guarding in that area that creates spasms if you move the wrong way?

And is the ONLY thing that causes pain when you actively hip flex? What about if you passively have your hip flexed? Can you extend your back without pain?

If you are getting muscle guarding/spasms I would suggest getting a cheap TENS unit and using it not ON the muscle problem but around it to alleviate any guarding/spasming. This will help the muscles calm down and allow you to leave the inflammatory phase much faster. Back muscles are notorious for staying in a protective phase when they are compromised which can delay the healing process. It's not really affective to stretch them... this can make it much worse.

I would try to rule out your psoas major from a back extensor injury. I'd do this by performing hip flexion while laying supine so that your back is relaxed and not focused on stabilizing your trunk/core while you do the movement. If you get the same pain, chances are it may be your psoas major. But if you notice a marked decrease in pain, it may be more extensor related. It's important to know so you can design a good rehab program so it doesn't happen again.

It's probably your psoas muscle (a hip flexor) going into spasms. You may have strained it a little.

Neliah2507: wrote:

I would try to rule out your psoas major from a back extensor injury. I'd do this by performing hip flexion while laying supine so that your back is relaxed and not focused on stabilizing your trunk/core while you do the movement. If you get the same pain, chances are it may be your psoas major. But if you notice a marked decrease in pain, it may be more extensor related. It's important to know so you can design a good rehab program so it doesn't happen again.

Psoas injuries are among the most common in distance runners, but one of the least known about. I had trouble in the early 80s and nobody I went to had a clue of the problem. I just gave up running for 18 years. When I started back, I had the same injury within 6 months and that is when I found out what the problem was. Go here (bottom of page) for a stretch you can do though you may not want to do the stretch until the muscle relaxes some.

1. muscles are gathering / gaurding. they are all tense and tight around the area.

2. The pain is in the lower left of the back, and there are several things that cause it to hurt.

-getting up from laying down.

-rotating to the right

-standing straight up hip flexing

-ronically leaning dramatically to either the right or left side pulls on the area causing pain.

(tried the laying down version... hip flexion did not cause pain)

3. any rehab program hints?

4. here's still hoping this heals up in a week or so and isn't a tendon issue.

5. do you think the standing straight up hip flexion... working through the kinks and pain will help alleviate / relax the muscle groups?

Thanks for the response.

glad to get some good information out here. it appears to be a rare issue.

One of two likely problems come to mind regarding your responses. It definitely sounds like it is more extensor related than hip flexor. However the culprit is most likely the fact your hip flexors are dominating your back extensors which predisposed you to the strain.

It's hard to narrow it down too much without over-speculating, but it sounds like you strained either your multifidus or your quadratus lumborum. Both of these muscles are located near the side of your lower back.

Your QL is a MAJOR postural muscle for activities like walking and running because it actively keeps you upright during those movements. It also works as a back extensor and lateral flexor of your spinal column (both of which you have pain with).

The multifidus is similar but smaller and deeper to your QL. Even though it's smaller it's a very STRONG set of muscles. The reason I am suspicious is because of the amount of muscle guarding you have. It's main purpose is to protect and support the spine so weight is distributed evenly between the discs; this means that before you do movements like extension/lateral flexion/etc, it's ALREADY activating in anticipation of those movements. Say you were about to get up from bed and you contracted your abdominals to sit up -- boom, back pain. It's already bracing in order to initiate that movement.

I know this is annoying to hear but the best thing to do is avoid running or any other impact activity (esp with hip flexion). I had a very similar issue over winter break and it refused to go away until I eliminated certain stressors. If I did the wrong movement (usually side bending or extension) it would set off a lot of guarding.

1. Get rid of all muscle guarding. I ended up spending 2 weeks in PT only to get pissed at having to spend 20$ co-pays for no relief. I stopped going to PT and got a tens unit on Amazon (mine was 65$ for a really nice portable one) but you can get very similar ones that will do the trick for about 30$. I used it about 3-4 times a day and it REALLY helped calm down the guarding. The less guarding I had the quicker my back loosened up and also the more mobility I had.

2. Avoid stretching the muscle. My chiro and also a PT kept insisting on doing this and every time I did their stretches my back would flip sh*t. Instead, I eased my way into activities that had slight hip flexion (elliptical with low incline). Then a few days later I started jogging/running but at a slow pace with lower hip flexion.

3. Massage. Massage. Massage. SO much more effective than stretching for a back muscle. Plus who doesn't love it? It will help get blood flow to the area and also loosen up any further tension/guarding.

I do have some good rehab exercises for back extensors and core but it's important that you get rid of the muscle guarding first otherwise you'll stay in a vicious cycle. Back muscles are really a b*tch to get under control but if you consistently baby them for a good 7-10 days you'll get over that hump and be OK. Shoot me an e-mail and I'll forward you a document or two with exercises I have saved.

Sorry ...forgot to include my address.

Also, I should note that a TENS unit is really a great purchase if you are a runner because it can really help to relax a lot of injuries besides this one. You just want to be careful and place the electrodes AROUND the strain and not directly on it. I would palpate the area or have someone help you locate the main pain location and then place the pads surrounding it.

This is very close to the one I bought:

http://www.amazon.com/Intensity-Micro-Combo-Electrotherapy-Unit/dp/B004TSN52E/ref=sr_1_8?ie=UTF8&qid=1331090790&sr=8-8

And I'm not pushing the unit, but if you find yourself 2-3 weeks from now stuck in a cycle of kinda feeling better than re-tweaking your back issue and still not being able to run...then I would definitely consider it. I wouldn't feel hardly any pain for 3-4 days at a time even when doing light runs, and then I'd lean over the wrong way in the shower and it would spasm because the strain was still there and it would take a day or two for the muscle guarding to go down. Your injury could very well be different though and heal quicker.

Sounds like Sciatica. Go see a good sports chiro and keep seeing him until you are pain free. I had this happen to me years ago and limped around for a month before my then girlfriend told me to just go see her chiro. Within a week I was back running.

You are out of balance.

How is the recovery coming along?