Epidural Injection and working out..

[Draven26]

So I got my epidural injection 4 days ago and I was wondering when it would be safe to go back to lifting normal.. somewhat heavy weights? I was thinking a week or so but just wanted to see what you guys thought? And also what kind of workouts should I do at the time being when I hit the gym? Any specific workout program or routine I should follow? I'm not trying to lose too much mass but I obviously want to recover fast.

Here is what the X-Rays showed:

5 lumbar type vertebrae are demonstrated. Mild/moderate chronic disc space narrowing at L5-S1. Minor thoracolumbar dextroscoliosis, seen in part. Vertebral body heights and alignment are preserved. The other disc spaces are unremarkable as are the posterier elements.

And the doctor pretty much said my bottom spine is thinned out. I don't know what he means by that but probably just from my previous construction jobs and other manual labor jobs I had in the past!

Anyways any kind of suggestions would help! Thanks

 

[flyhighk]

What did they inject ? Depo-medrol ?

 

[CFC]

What's the backstory with the epidural? What's the problem? Why (and what was) the injection? And how old are you? Have you had an MRI?

 

[Draven26]

I'm 28 years old and I've had back problems for the last 5 years or so from my previous jobs. Construction and I was a stock clerk at a grocery store for 4 and a half years. They gave me the epidural steroid injection to treat pain. I haven't had an MRI done yet.. just the X-Rays at the ER

 

[CFC]

Ok, for back problems I usually assume some degree of disc herniation has occurred, but an MRI would be necessary to show that really. Also you're mildly scoliotic so there's an underlying issue of slightly increased shearing forces whenever you load your spine. That could cause pressure on the nerve and hence pain, but also the disc space narrowing between L5-S1 could well be a result of the bulging of its contents or sheathe pressing onto the nerve.

When they talk about the spine being 'thinned out' they usually mean the discs are drying up. That's usually something that doesn't happen until people are older (like 40-50) and the discs become quite 'dry' or 'fused'.

With regards to training, you'd be fine to start again now. Although it seems counterintuitive, people usually benefit tremendously from a routine that really prioritises the back, spinal erectors and posterior chain - eg deadlifts, very carefully performed good-mornings etc. The thicker and more powerful the muscles along your spine, the better supported and better coordinated it becomes. And also the carefully controlled use of the joints can actually calm excessive inflammation.

You really need to make sure you do not TWIST while your spine is under load though. That includes especially while at work - construction is notorious for this. The discs are amazing things and can easily take massive compressive loads (tons of pressure). However, even a slight twist under that load could weaken or tear the sheathe that holds it all together >>> herniation.

 

[Draven26]

Ok, for back problems I usually assume some degree of disc herniation has occurred, but an MRI would be necessary to show that really. Also you're mildly scoliotic so there's an underlying issue of slightly increased shearing forces whenever you load your spine. That could cause pressure on the nerve and hence pain, but also the disc space narrowing between L5-S1 could well be a result of the bulging of its contents or sheathe pressing onto the nerve.

When they talk about the spine being 'thinned out' they usually mean the discs are drying up. That's usually something that doesn't happen until people are older (like 40-50) and the discs become quite 'dry' or 'fused'.

With regards to training, you'd be fine to start again now. Although it seems counterintuitive, people usually benefit tremendously from a routine that really prioritises the back, spinal erectors and posterior chain - eg deadlifts, very carefully performed good-mornings etc. The thicker and more powerful the muscles along your spine, the better supported and better coordinated it becomes. And also the carefully controlled use of the joints can actually calm excessive inflammation.

You really need to make sure you do not TWIST while your spine is under load though. That includes especially while at work - construction is notorious for this. The discs are amazing things and can easily take massive compressive loads (tons of pressure). However, even a slight twist under that load could weaken or tear the sheathe that holds it all together >>> herniation.

So you think I'm fine to do deadlifts and good mornings. How much weight should I do with deadlifts and how many sets/reps. Same with good mornings. I've never done good mornings as I've heard that can further injure your back but I don't know. Let me know what you suggest I do to strengthen my back. Also, will MK677 (Ibutamoren) help the bones heal? I was thinking of adding it along with my TRT. Just whenever I can afford it.. do a month cycle of it and hopefully that'll strengthen the bones in my back but I figure I would get your opinion on that if you think it'll help. I just want to be able to lift somewhat heavy weights because I worked so hard to get to my size. I was at 210 but now I'm 195 since going very light with the weights and I don't want to weight any less then that to be honest so I don't know. and I take Calcium/Magnesium as well as Vitamin D and MSM with Chondroitin.

 

[CFC]

So you think I'm fine to do deadlifts and good mornings. How much weight should I do with deadlifts and how many sets/reps. Same with good mornings. I've never done good mornings as I've heard that can further injure your back but I don't know. Let me know what you suggest I do to strengthen my back. Also, will MK677 (Ibutamoren) help the bones heal? I was thinking of adding it along with my TRT. Just whenever I can afford it.. do a month cycle of it and hopefully that'll strengthen the bones in my back but I figure I would get your opinion on that if you think it'll help. I just want to be able to lift somewhat heavy weights because I worked so hard to get to my size. I was at 210 but now I'm 195 since going very light with the weights and I don't want to weight any less then that to be honest so I don't know. and I take Calcium/Magnesium as well as Vitamin D and MSM with Chondroitin.

If you've never done good-mornings, just stick with back extensions for now. But no, they would not injure your back performed properly. Just start light and easy with your deadlifts, and slowly build up intensity and weight. Be sensible.

Is there any particular reason you've chosen Ibutamoren over Mod-GRF/GHRP-2? Personally I'd go with the latter combo. BTW it's not your bones that need fixing, it's your joints/discs. But yes, boosting GH may improve healing.

As far as bodyweight etc, take a long-term view. It's pretty easy to gain back weight, so there's no need to panic. It's better to take things slow and not cause any further injuries. You need to be careful with your back for the rest of your life, so you'll have to adjust training (and also how you lift/carry heavy weights at work) permanently.

 

[Draven26]

If you've never done good-mornings, just stick with back extensions for now. But no, they would not injure your back performed properly. Just start light and easy with your deadlifts, and slowly build up intensity and weight. Be sensible.

Is there any particular reason you've chosen Ibutamoren over Mod-GRF/GHRP-2? Personally I'd go with the latter combo. BTW it's not your bones that need fixing, it's your joints/discs. But yes, boosting GH may improve healing.

As far as bodyweight etc, take a long-term view. It's pretty easy to gain back weight, so there's no need to panic. It's better to take things slow and not cause any further injuries. You need to be careful with your back for the rest of your life, so you'll have to adjust training (and also how you lift/carry heavy weights at work) permanently.

My wife won't let me inject myself because of my past with Meth. I've been 3 years clean. But she just doesn't want needles in the house.. so I understand her concern with that. So I have to go in everytime to get my test cyp injection for TRT which is no big deal. It's whatever! And as far as the MK677 I found a liquid research chemical version of it so I figure just go with that. Mod-GRF/GHRP-2 are all injectables. That would be awesome if they come out with a liquid oral for those! But for now I'll have to just try the MK677 and see how it goes.

Also I wanted to know your opinion. I have done 1 epidural and my insurance covers two more. Should I get the other two right away or should I wait a couple of months since I just got this first one. Because I really want to do a cycle in June and if I do my 2nd epidural than I'll have to wait a week to 10 days for the hole to heal and I don't want to do lightweights forever you know? So do you think it's fine if I wait to do the other two epidurals later?

 

[CFC]

No, you don't need the other injections yet. You may not need them at all - the determinant should be pain and inflammation really. This shouldn't really affect your cycle plans either way though. Are they going to give you an MRI at any point?

As for weight, you really need to be careful, don't push yourself too hard, especially if you go on cycle and strength shoots up. I know it's annoying but you obviously have some serious evolving back issues that won't go away and will be made worse if you lift too much too soon.

 

[Draven26]

No, you don't need the other injections yet. You may not need them at all - the determinant should be pain and inflammation really. This shouldn't really affect your cycle plans either way though. Are they going to give you an MRI at any point?

As for weight, you really need to be careful, don't push yourself too hard, especially if you go on cycle and strength shoots up. I know it's annoying but you obviously have some serious evolving back issues that won't go away and will be made worse if you lift too much too soon.

Okay I'll definitely be careful with weight even if my strength increases. And as far as another epidural shot how long you think till I should get another one? Like in the next 6 months or so? I should be good for a while, right? The doctor is making it seem that each epidural shot should get better each time I get it but I don't want to get another one too soon and then have to wait for it to heal before I can lift normal again you know? Yeah I'm going to hopefully make an appointment with my primary doctor to schedule an MRI!

 

[CFC]

An ESI usually involves a long-acting steroid (eg betamethasone or triamcinolone). How long the anti-inflammatory/pain effect lasts depends on how bad the herniation/bulge is, how badly it presses on the nerve etc. Without an MRI its difficult to know how severe the underlying issue is. However, I'd expect the carefully performed back exercises to help regardless.

The case for another injection should be based on pain not on time; your doctor is misleading you somewhat, although I understand what he's getting at. There's always a fine balance between joint degeneration and preservation with the use of steroids. Healing of sheath tissue takes months and a high degree of inflammation will tend to produce rapid scar formation and further inflammation, hence the aggressive use of steroids. However steroids can also cause the tissues to degenerate and weaken further (because they slow healing) and thus make things worse.

As long as the pain is tolerable, avoid another injection for now, resume exercising and play it by ear.

 

[Draven26]

An ESI usually involves a long-acting steroid (eg betamethasone or triamcinolone). How long the anti-inflammatory/pain effect lasts depends on how bad the herniation/bulge is, how badly it presses on the nerve etc. Without an MRI its difficult to know how severe the underlying issue is. However, I'd expect the carefully performed back exercises to help regardless.

The case for another injection should be based on pain not on time; your doctor is misleading you somewhat, although I understand what he's getting at. There's always a fine balance between joint degeneration and preservation with the use of steroids. Healing of sheath tissue takes months and a high degree of inflammation will tend to produce rapid scar formation and further inflammation, hence the aggressive use of steroids. However steroids can also cause the tissues to degenerate and weaken further (because they slow healing) and thus make things worse.

As long as the pain is tolerable, avoid another injection for now, resume exercising and play it by ear.

Yeah because there's still pain but I don't want to get another epidural right now because it hasn't even been a month yet. I'll do the exercises carefully and work on my core. Will yoga help? That's what everyone keeps saying is do yoga. It can be something I can do with the wife I guess and try it out. I'll wait a couple of months to get another injection though for sure! And when I do get another injection.. how long do you thing I should wait till I go heavy again or somewhat heavy on exercises? Like is it safe to get the epidural steroid injection and go back to the waits or should one go walking only for a week to 10 days before lifting weights?

 

[CFC]

Yeah because there's still pain but I don't want to get another epidural right now because it hasn't even been a month yet. I'll do the exercises carefully and work on my core. Will yoga help? That's what everyone keeps saying is do yoga. It can be something I can do with the wife I guess and try it out. I'll wait a couple of months to get another injection though for sure! And when I do get another injection.. how long do you thing I should wait till I go heavy again or somewhat heavy on exercises? Like is it safe to get the epidural steroid injection and go back to the waits or should one go walking only for a week to 10 days before lifting weights?

Try a few weights sessions working very carefully with your back, and assess the pain. A significant increase would imply the inflammation is still not under control and may warrant another injection. The injections themselves don't really have much bearing on when you can exercise - just give it a day.

You need to strengthen the muscles and work on coordination/neuromuscular proprioception and in my experience Yoga isn't particularly helpful and can sometimes worsen back problems, especially if you're new to it. Stick to weights rehabbing for now.

 

[Draven26]

Try a few weights sessions working very carefully with your back, and assess the pain. A significant increase would imply the inflammation is still not under control and may warrant another injection. The injections themselves don't really have much bearing on when you can exercise - just give it a day.

You need to strengthen the muscles and work on coordination/neuromuscular proprioception and in my experience Yoga isn't particularly helpful and can sometimes worsen back problems, especially if you're new to it. Stick to weights rehabbing for now.

So basically good mornings with really light weights and back extensions, right? Anything else? Yeah I want to do another injection because the pain is still there. I did arms last night and I did my best not to go too heavy.. it's definitely difficult for me though because I don't want to lose too much size you know? But I figure do my cycle next month and enjoy the beach and water park with my wife and get some decent results on the cycle and in a couple of months after that if it's still giving me a hard time I'll just get the epidural. I just want to be able to get a job and not have to injure myself and get laid off again you know? I can't afford to keep getting laid off every time and it pisses me off cuz I'm a hard worker.. it's just my back's been giving me a problem for years now! I'll definitely get the MRI done so we can figure out the problem.

As for surgery.. what is your opinion on that? A lot of people say they feel great and can walk the next day but they always say if they could go back, they would of never gotten the back surgery and that freaks me out a bit! If you feel great afterwards why do you regret getting the back surgery? Back surgery isn't that simple is it? Like if it's the lower disc that's thinned out.. would would they replace it with if I did the back surgery? Or would you not recommend it at all?

 

[CFC]

Spinal surgery is not to be taken lightly. There are very serious risks from any procedure. This tends to be glossed over, but it's still very much a reality. You can read a little about it all here: http://www.nhs.uk/conditions/Lumbardecompressivesurgery/Pages/Whatisitpage.aspx

However, that would be an absolute last resort, I'd consider every other option first. The fact that you are still obviously mobile suggests you're definitely not really in need of something that extreme yet.

For some other ideas, there are assistive devices you could try that look a bit like a powerlifting belts and help reduce both flexion of and shearing forces upon the discs.

You could also attempt several sessions of decompression via mechanical spinal traction with a good osteopath. Often this is quite pricey and many describe little improvement. Combined with exercise it may be better.

However generally speaking the best rehab option is exercise. Deadlifts, back extensions, good mornings (all performed as CAREFULLY and sensibly as possible) are all good options.

 

[Draven26]

Spinal surgery is not to be taken lightly. There are very serious risks from any procedure. This tends to be glossed over, but it's still very much a reality. You can read a little about it all here: http://www.nhs.uk/conditions/Lumbardecompressivesurgery/Pages/Whatisitpage.aspx

However, that would be an absolute last resort, I'd consider every other option first. The fact that you are still obviously mobile suggests you're definitely not really in need of something that extreme yet.

For some other ideas, there are assistive devices you could try that look a bit like a powerlifting belts and help reduce both flexion of and shearing forces upon the discs.

You could also attempt several sessions of decompression via mechanical spinal traction with a good osteopath. Often this is quite pricey and many describe little improvement. Combined with exercise it may be better.

However generally speaking the best rehab option is exercise. Deadlifts, back extensions, good mornings (all performed as CAREFULLY and sensibly as possible) are all good options.

Awesome.. what about inversion tables? I have one at home but I haven't used it in a while. Do you think those would work over time? Like 5-10 minutes a day for pain relief and at least help with my scoliosis?

 

[CFC]

It may provide some minor pain relief. You'd probably benefit more if you could bend your knees up until your lower back touches the table, as this straightens out your lumbar vertebrae properly for a more effective decompression of the most likely suspects (L4/5/S1). Most tables don't really allow you to do that though. I'm unsure the scoliotic issues would improve much as even partially correcting the curvature requires pretty hardcore bracing devices.

 

[Draven26]

It may provide some minor pain relief. You'd probably benefit more if you could bend your knees up until your lower back touches the table, as this straightens out your lumbar vertebrae properly for a more effective decompression of the most likely suspects (L4/5/S1). Most tables don't really allow you to do that though. I'm unsure the scoliotic issues would improve much as even partially correcting the curvature requires pretty hardcore bracing devices.

Yeah I know I wish I could bend my knees until my lower back touches the table and be able to hold myself up but haha I'm not 170 pounds anymore.. I'm 195 and it's a little difficult to hold myself up haha but yeah I'll definitely use and hopefully over time it'll help with my scoliosis!