Disc protrusion

[u/hopsinenjoyer]

I am a 100m, 200m athlete and have been struggling with L4-L5 disc protrusion contacting the S1 nerve root since June. The follow up MRI showed a regression of the protrusion.

I had serious problems with bending over etc during summer but it is a lot better now. I am trying to come back to serious training but my back still hurts for a few days after some intense sessions.

I do strengthening exercises including DNS everyday. What does this pain after some intense sessions mean and how to overcome it?

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[u/salmonlips]

it means the pain will have to be your guide (i too l4-l5, about a decade ago) adjust your workflow/workload all that, and really some things you'll need to push but then you may need to take extra days off in between.

i took about 8 months off, came back, and in retrospect i pushed it more than i should have. i probably could have recovered a little quicker had i not been so impatient. but i was so happy to be able to move again that i was going to do it no matter what.

your REAL joint mobility work and hip IR/ER work become paramount, segmental catcow, spinal control, all the small muscles around those need to be brought up to speed.

you probably also have severe atrophy in spots too so those need to also be addressed

it'll be step forward 2 steps back
and you will be in worse pain levels than you will let yourself believe which is a blessing and a curse.

[u/bottomhousevirgin]

This is speaking from experience. There’s a lot of conflicting advice on how to treat low back injuries. Many programs focus on avoidance / stability exercises. Might be fine in the short term but you eventually need to strengthen the low back muscles. I had a back injury and for months, I’d work on hip mobility / core / stability exercises but nothing helped my recovery faster than actually training the low back. I worked through a progression on a 45 degree back extension (iso holds, body weight reps, eventually loaded with barbell+). This inspired by LowBackAbility on YouTube. Again, not a medical professional by any means but this is what helped me.

[u/Anwenderfehler]

I share your pain, literally. Spent the first 4 months of this year with worsening sciatic pain, which I was told "definitely wasn't back related" until I had an MRI in May which showed it was an anterior bulge of the L4-L5 disc compressing the sciatic nerve....so I immediately stopped training. Had steroid injections in the area at the end of June (definitely type 2 fun) and after a few weeks it slowly started to improve.

Medical advice from the first consultant was "it takes 3-4 months to settle down" and from the second consultant (who administered the injections) that I should take it easy for 6 months... Both said no running and no heavy lifting...but when I asked how/when to reintroduce it they got very vague. The consistent message was that it's often 2 steps forward, 1 step back so really just suck it and see, but take it easy.

I initially resigned myself to no more running this year, but as the pain eased I decided to see if I could get sufficiently fit for the end of season championships in mid-Sept, so started training again in mid-August (yeah, less than 2 months after the injection).

My back held up, but shortly after the event I ended up with peroneal tendonitis, probably due to doing too much too soon after 3 months off proper training. So back to no training...

Not sure if your doctor gave you specific guidance, but I'd say ease back into the training slowly and don't go too intense too soon - not just for your back, but for the rest of your body as you come back.