Just hurt my back!

[lee9786]

Doing leg presses of all things. This is actually the second time in 6 months. The first time was at home exercising doing curls. I was sitting down, and when I went to put the weights I put them down wrong. Then I felt it. Didn't seem too bad at the time. Although now I have the feeling this is going to be a recurring problem that plagues me for life. Unfortunately I don't have insurance right now to go see a PT. Very discouraging. Couldn't have come at a better time. I'm trying to stay positive. I sure hope this doesn't destroy my aspirations for becoming a physical therapist.

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[Akiramay]

Sorry to hear that! I don't think it will stop you from being a PT. Where is your back hurting exactly? Hope you recover soon!

 

[lee9786]

Sorry to hear that! I don't think it will stop you from being a PT. Where is your back hurting exactly? Hope you recover soon!

The lower lumbar area. Around L2 or L3 I believe. Sometimes you learn the hard way. I'm a little better today than yesterday when it happened. I could barely stand up an hour after it happened. I still am very carefully with moving in general. I'm amazed that a leg press machine of all things caused this to happen. I was aware of my back issue the entire time and tried to do perfect form. I didn't even have a lot of weight on (145lbs). I was doing 15 reps. I was under the impression it would actually strengthen the muscle tone in the lower back, which I've been trying to do gradually since the first time it happened. Boy was I wrong. Oh well maybe we can all learn from this. I guess all the weight was directed to that region. Sends chills up my spine thinking about it. Literally.. lol no wait that's pain.

 

[Cronos]

That blows man. I couldn't imagine worrying about my back for anything. Let alone how it may affect your future job. I worry about a ganglion cyst on my wrist that has recently gotten worse, though still only the size of a marble. Don't want something like that annoying me throughout my career. Little frusterating but I have yet to whack it with a book or anything like that

Hope your recovery continue to goes well.

 

[PTtoBe]

Howdy lee, sorry to hear about it. I don't think this is likely to jeopardize your PT aspirations or anything like that, though. From what I've read, nearly every body who is very active (works with weights, etc.) runs into lower back pain at some point. Just give it some rest for now, and maybe consider picking up this McKenzie book:

http://www.amazon.com/Treat-Your-Back-Robin-McKenzie/dp/0958269238/ref=pd_sim_b_2

You may also consider going to an outpatient PT clinic and just explaining to them that you can only pay out of pocket for 3 sessions or so, if they could at least evaluate and give you some self-treatment guidelines in that timeframe. Not sure how PTs typically handle that type of situation, but I imagine they'd be flexible.

By the way, thanks for your post...it serves as a good reminder to many of us who are active with weights and the like routinely to be wary. I do squats/dead lifts and other intense exercises and am always paranoid about hurting my back. There was one time a couple years ago that I popped out some ribs while doing curls/reverse curls. I was in pain for a couple days (it was immobilizing right after it happened...I could barely make any movement above my waist for several hours) but after that was right back to transferring patients as my job as an aide, with some soreness. An OT felt a couple of the ribs that had popped out of the vertebrae and pushed them back in.

 

[WillWords]

I know most PTs think chiropractors are the anit-christ, but, I've been lifting for years and I swear by them. I injured my back doing a rack deadlift, rested it for three months while using a light rehab routine and it got worse! After about 10 sessions with the chiro (about a month and half) my back was 95%.

 

[facetguy]

I know most PTs think chiropractors are the anit-christ, but, I've been lifting for years and I swear by them. I injured my back doing a rack deadlift, rested it for three months while using a light rehab routine and it got worse! After about 10 sessions with the chiro (about a month and half) my back was 95%.

Bracing for impact...

 

[jesse14]

I know most PTs think chiropractors are the anit-christ, but, I've been lifting for years and I swear by them. I injured my back doing a rack deadlift, rested it for three months while using a light rehab routine and it got worse! After about 10 sessions with the chiro (about a month and half) my back was 95%.

chances are, if you didn't do anything for your back in those 6 weeks, youre pain would have gone away on it's own...manipulation has no scientific validity except for relaxing local muscle spasm..temporary effect. That's why so many patients leave their chiro feeling great for 30-45 minutes after threapy and low and behold, they are in pain again within a few hours. What most chiros fail to do is treat the cause of the pain. Manipulation is akin to a pill...it masks the problem (but not in all cases)

 

[facetguy]

chances are, if you didn't do anything for your back in those 6 weeks, youre pain would have gone away on it's own...manipulation has no scientific validity except for relaxing local muscle spasm..temporary effect. That's why so many patients leave their chiro feeling great for 30-45 minutes after threapy and low and behold, they are in pain again within a few hours. What most chiros fail to do is treat the cause of the pain. Manipulation is akin to a pill...it masks the problem (but not in all cases)

jess, that's a little (or a lot) misleading. Folks, do your own homework on manipulation, or on chiro if you are so inclined. Don't form an opinion on less-than-complete information.

 

[MinnDasota]

Facetguy, I do understand where you're coming from and manips have been shown useful with the correct diagnosis and appropriate rehab. The inappropriate rehab (or incorrect diagnosis by the chiro) is why I find some chiro patients in my clinic.

There are many PTs that have been taught to do grade 5 mobs (very very similar to a manip) and do use it (although limited in some state laws). We wouldn't be using it if it wasn't effective or if there wasn't research behind it. Honestly, I think many PTs are just uncomfortable using it. However, it is most effective when used to rehab the "cause" of the pain. If a person does feel better but feels that they have to continue to come back week after week to get manip'd, then most likely the treatment is only treating the pain and not the cause of the pain.

Willwords, did you see a PT for the light rehab or was it your own routine? If you did see a PT, please don't post about the ineffectiveness of PT in a PT forum without backing up what the PT did. Just like in any field, you may have had a PT not as well trained in the back as another.

Lee, hope your back feels better!!

 

[facetguy]

Facetguy, I do understand where you're coming from and manips have been shown useful with the correct diagnosis and appropriate rehab. The inappropriate rehab (or incorrect diagnosis by the chiro) is why I find some chiro patients in my clinic.

There are many PTs that have been taught to do grade 5 mobs (very very similar to a manip) and do use it (although limited in some state laws). We wouldn't be using it if it wasn't effective or if there wasn't research behind it. Honestly, I think many PTs are just uncomfortable using it. However, it is most effective when used to rehab the "cause" of the pain. If a person does feel better but feels that they have to continue to come back week after week to get manip'd, then most likely the treatment is only treating the pain and not the cause of the pain.

Exercise is important, which is why many chiros (more and more chiros) recommend it. Not speaking for every chiro out there, but the idea that chiros ONLY perform manipulation then walk out of the room without another word is false.

As to the effectiveness of manipulation, it has been interesting to watch over the recent years as more PTs have taken to it. Maybe those crazy DCs are onto something (and have been for 100+ years)!

[By the way, this isn't meant to be a 'DCs do it better than PTs' thing. I refer patients to PTs and have treated several PTs over the years.]

 

[Elbrus]

There are many PTs that have been taught to do grade 5 mobs (very very similar to a manip) and do use it (although limited in some state laws)

A grade V mobilization is not very similar, it is a thrust manipulation and a CAPTE requirement for all schools. Because of petty legislation in a few states, it just has various names for the same thing. Here is some great background information on the topic & well worth reading if you are not famililar.

 

[jesse14]

jess, that's a little (or a lot) misleading. Folks, do your own homework on manipulation, or on chiro if you are so inclined. Don't form an opinion on less-than-complete information.

How is that misleading? I'm summing up the latest research. Childs and Fritz defined 5 CPR's for manip. I.e the more of the following symptoms, the better they will respond to no more that THREE (3) trials of manipulation. The Clinical Predication Rules for SMT include:
1) Pain <16 days
2) Hip IR >35 degrees of at least one hip
3) No symtoms distal to the knee
4) Fear Avoidance belefs questionaire (FABQ) score <19
5) Lumbar segmental hypomobility as judged by a PA of a spinous process (this last one is debatable because the inter and intra-rater validity of palpation is poor at best)

patients who present with 4/5 of these symptoms the patient has a 92% success rate with manipulation....problem is, a great number of chiro patients do not fit the aforementioned criteria and thus would not respond as favourably to manipulation...especially the 3X a week for the rest of your life some chiros like to prescribe! Don't get me started on the whole "the onus is on the patient to get better" idea that some chiros refuse to acknowledge...they make patients passive bystanders in their own healthcare.

Basically, SOOO many chiros manip every patient that comes into their office...that, in my opinion, is unethical. There are MANY more patients that would benefit much more from say deep core stabilizer exercises (TrA, pelvic floor, multifidus etc). So yes, i did generalize and i know there are some fantastic evidenced based chiros out there but from my experience, they are far and few between... and trust me, i have plenty of chiro-related experiences!

 

[WillWords]

chances are, if you didn't do anything for your back in those 6 weeks, youre pain would have gone away on it's own...manipulation has no scientific validity except for relaxing local muscle spasm..temporary effect. That's why so many patients leave their chiro feeling great for 30-45 minutes after threapy and low and behold, they are in pain again within a few hours. What most chiros fail to do is treat the cause of the pain. Manipulation is akin to a pill...it masks the problem (but not in all cases)

Well, if the cause of the pain is subluxation, then they do treat the cause of the pain.

I can not speak to whether or not manipulation is scientifically valid. On a purely intuitive level, it would seem to make sense that if something on your body is out of place (dislocated shoulder), it would make sense to try put it back into its proper place.

Btw, PTs are taught to manipulate, so if it didn't have some merit... why do they teach it to us?

 

[facetguy]

How is that misleading? I'm summing up the latest research. Childs and Fritz defined 5 CPR's for manip. I.e the more of the following symptoms, the better they will respond to no more that THREE (3) trials of manipulation. The Clinical Predication Rules for SMT include:
1) Pain <16 days
2) Hip IR >35 degrees of at least one hip
3) No symtoms distal to the knee
4) Fear Avoidance belefs questionaire (FABQ) score <19
5) Lumbar segmental hypomobility as judged by a PA of a spinous process (this last one is debatable because the inter and intra-rater validity of palpation is poor at best)

patients who present with 4/5 of these symptoms the patient has a 92% success rate with manipulation....problem is, a great number of chiro patients do not fit the aforementioned criteria and thus would not respond as favourably to manipulation...especially the 3X a week for the rest of your life some chiros like to prescribe! Don't get me started on the whole "the onus is on the patient to get better" idea that some chiros refuse to acknowledge...they make patients passive bystanders in their own healthcare.

Basically, SOOO many chiros manip every patient that comes into their office...that, in my opinion, is unethical. There are MANY more patients that would benefit much more from say deep core stabilizer exercises (TrA, pelvic floor, multifidus etc). So yes, i did generalize and i know there are some fantastic evidenced based chiros out there but from my experience, they are far and few between... and trust me, i have plenty of chiro-related experiences!

These are guidelines, from one study. This is not the word of God. Can they be useful? Sure. But be careful about basing your entire practice on a single study. It has been my experience, and there is literature that agrees, that SMT can be very effective for subacute and chronic cases, so the 'pain <16 days' should be taken with a big grain of salt.

I think you were just kidding about the 3x/wk for life. And, yes, SMT is a passive modality, which is why (as I'd mentioned earlier) that more and more chiros are recommending active components to care.

 

[facetguy]

Well, if the cause of the pain is subluxation, then they do treat the cause of the pain.

Yeah, the subluxation thing. Probably not the best choice of terminology. In reality, though, it is just an effort to describe the effects associated with a functional problem. Effects including the altered local neurology (e.g., altered mechanoreceptor firing), inflammatory changes, reflex muscular spasm, etc. I think DOs call it 'somatic dysfunction', others have referred to it as 'functional spinal lesion' or 'manipulable lesion'. It doesn't have to mean it's the cause of every known disease.

I can not speak to whether or not manipulation is scientifically valid. On a purely intuitive level, it would seem to make sense that if something on your body is out of place (dislocated shoulder), it would make sense to try put it back into its proper place.

It's really more a matter of restoring normal motion and articular neurology than it is 'popping' something back into place. Most patients believe one of their vertebra has jumped off track and I am putting it back for them. That's not exactly reality.

Btw, PTs are taught to manipulate, so if it didn't have some merit... why do they teach it to us?

Answer: because it works. The issue PTs try to squirm around is how do you say that without giving at least some credence to chiros.

 

[lee9786]

I don't trust chiropractors treating me. I've heard too much shady business being thrown around. Some to the admittance of Chiros themselves. I don't think Chiropractors are bad people or unethical. I think a majority decided to go into the profession to help others. I do think there is plenty of deceptional and unethical recruiting going on at the collegiate level. There is way too many false promises to potential graduates. Their high level of loan defaults says it all.

I'm at a total loss for what the Chiropractic profession will be 20 years from now. It's not looking so good from my point of view.

To make a long story short, I'd rather pay more out of pocket for a PT to treat me because I trust their decisions.

 

[truthseeker]

To those that are comparing mainpulations between PTs and DCs I would say this. There are no (or very very very few) PTs that claim that a manipulation is the answer for asthma, hypertension, bedwetting etc . . . I have no problem with spinal manipulations, what I do have a huge problem are the straights that believe ( and believe is the operative word here) that subluxations (if in fact they do exist and aren't just an artificial construct to validate a profession) are the cause of all ills, thus manipulations or adjustments are the cure of everything medical, infectious, and musculoskeletal.

I may be confused but I remember a paper from some reporter in Davenport IA that went to several different DCs with the same exact Xrays and there was no reliability between the chiros about where exactly the subluxations were.

 

[facetguy]

To those that are comparing mainpulations between PTs and DCs I would say this. There are no (or very very very few) PTs that claim that a manipulation is the answer for asthma, hypertension, bedwetting etc . . . I have no problem with spinal manipulations, what I do have a huge problem are the straights that believe ( and believe is the operative word here) that subluxations (if in fact they do exist and aren't just an artificial construct to validate a profession) are the cause of all ills, thus manipulations or adjustments are the cure of everything medical, infectious, and musculoskeletal.

I may be confused but I remember a paper from some reporter in Davenport IA that went to several different DCs with the same exact Xrays and there was no reliability between the chiros about where exactly the subluxations were.

(I'll just say this real quick and then end it there, because I don't want to feed into the us vs. them thing that doesn't need to exist in the first place.)

There are fewer and fewer DCs (I would say very few) that believe they can cure "everything medical". Remember, there is the little issue of malpractice, and I don't know too many DCs who want to get sued. Oh, and the fact that manipulation clearly doesn't work for everything.

As to the xray thing, that's why we shouldn't use xray (at least not in isolation) to determine where a patient's dysfunction may be. I never do, nor was I taught to during any part of my chiro school training.

 

[exrx]

Doing leg presses of all things. This is actually the second time in 6 months. The first time was at home exercising doing curls. I was sitting down, and when I went to put the weights I put them down wrong. Then I felt it. Didn't seem too bad at the time. Although now I have the feeling this is going to be a recurring problem that plagues me for life. Unfortunately I don't have insurance right now to go see a PT. Very discouraging. Couldn't have come at a better time. I'm trying to stay positive. I sure hope this doesn't destroy my aspirations for becoming a physical therapist.

Back to the original problem before this got into a PT v. chiro debate; one of the posters already mentioned McKenzie's book but you might also try anything written or published by Stuart McGill. He seems to be one of the best authorities when it comes to spine biomechanics. I know he has two books out with recent updated editions. In any event, there are a plethora of treatment/training philosophies out there. Not one method will work across the board.

 

[clo]

First time posting here, I was searching for some info for PT and found this thread. I am not a PT; but I am a Personal Trainer and have been one for over 12 years. I'm on this forum because I'm looking to go back to school for PT.

Anyways, back to the post. It's not uncommon to see this happen. I've seen and heard complaints of low back pain after doing the leg press countless times. MOST of the time I've found it to be either poor form or positioning on the machine.

Back should be flat against the pad maintaining a neutral spine and the butte should also be on the bottom pad. Correct ROM should take you down to 90 deg or just slightly below keeping the butte on the pad the whole time. If the butte starts to roll up off the pad you will start to engage the low back muscles. This is not good. This particular exercise is for quads, glutes and hamstrings only.

If you are trying to strengthen the muscles in the back you'll need to focus on core exercises for the deeper stabilizer muscles and/or your traditional hyperextensions. HOWEVER, considering what happened to you I'd say you'll need to start concentrating on the deepr stabilizer muscles to gain some strength back.

I hope that helps! I'm on to my search. I have alot of questions about getting into this program!

I'm amazed that a leg press machine of all things caused this to happen.
I was under the impression it would actually strengthen the muscle tone in the lower back, which I've been trying to do gradually since the first time it happened.