I've had some chronic low back pain that I'm working on in physical therapy, 2 months or so now. So my question is how to incorporate lifting heavy into my workouts? kettlebell? body weight exercises instead? just wait it out till the back gets better (which it's likely never to be 100%)?
Speaking only from personal experience, I know that my body works better when its trained to work better. I used to have back pain, have dislocated my shoulder (torn cartilage), messed up knees, ankles, etc. I know everything feels better, works better and stronger when its trained habitually using the proper form and types of excercies. When I stop for more than a month, all my nagging injuries start to show up again. Also, when starting out its going to be painful, its best to do some type of rehab so you learn whats good pain and whats bad pain (for this particular injury).
You are going to have to do your own research into the excercies you need to be doing, but start off light and focus on form, form, and form. Then, as time goes on you will know when you are ready to go heavy (deadlifts are your best friend for back pain... as ironic as it may seem, but its really not). Just remember form is more important than the weight, doesn't matter if you are 200lbs deadlifting a 45lb bar for 5 reps, it will make you feel like a million bucks down the road if you do it right.
All that said, I am not a doctor and I don't know your specific problem, so take every thing I said with a grain of salt and do what you ultimately think is right. Also, if you are in doubt, just ask yourself if what are doing is worth it. Lifting an extra 5lbs might boost your self-esteem but might also be the needle on the camel's back (is that how the saying goes?).
I have low back issues. Well, had low back issues. I had them every day for 15 years, for about a pain scale of 6-8. At points it ruined my life, or just made me plain miserable. I've gotten rid of that in the last 3 months or so. I'm not a doctor, but this is what worked for me. Use at your own risk...
Check out active release techniques. Seriously, I didn't realize how messed up my body was till I went in for a treatment. Really helped with movement and muscle stabilization issues. http://www.activerelease.com/
See if you can find a RKC in your area and learn how to do the kettlebell swing. I credit the swing for fixing it. Several weeks of doing 2 sessions with 200-300 swings and I got rid of the pain. If you're having this pain and stuff, make sure they know ck-fms (movement stuff). http://www.dragondoor.com/instructors/rkc_instructors/
Check out MWoD. I do a session a day (starting at #1), and I've noticed I move, squat, lift and feel better. http://www.mobilitywod.com/
Strength training builds, well, strength and significant flexibility which can help to restore some mobility and function. Form is king, and with sound lifting mechanics and as many warm-up sets as needed, it's difficult to injure yourself without moving more weight than proper form allows.
I don't know a lot about CrossFit, so I can't say much about that. Paleo people seem to experience awesome results doing CrossFit, so maybe give that a shot.
As for my own experience, for most of my life, and I'm only 22, I've had awful thoracic back pain. Being cognizant of my posture at all times and doing strength training has totally vanquished my back pain in less than a year. Keep those shoulder blades retracted, lumbar in extension, abs tightened, and the chest elevated while you walk and work out. Worked for me.
I had a lot of back trouble for a few years. It seemed to be caused by a bacteria problem in the joints. A bacteria that feeds off starches, I was told. Cutting out the starches, helped but didn't fix the imbalance that had been caused. Pushups helped but what really helps me are deadlifts performed with bands instead of weights.
Well if you're working with a PT, it seems like this would best be addressed to your PT. You have to start with what exactly is the nature of your injury? Do you have a disc injury or a muscle tear? There's just some injuries where lifting heavy would be stupid and counterproductive. That you've been doing PT for 2 months now suggests to me you're dealing with a fairly serious back injury and there's probably a reason the PT hasn't recommend you get back into deadlifting yet.
Very similar situation, although I'm adding in some fairly serious muscle imbalance and stability issues that stem from a road biking accident that have never been properly treated (until now).
I agree with two suggestions above: minimalist shoes (Vibrams for me) in the gym, and active release. Both have given my healing and training about a 3 month boost, for sure.
I would also add that the single most effective thing I have done in...well, ever...is to seek out a PT that is also a strength and conditioning coach certified in FMS. The Functional Mobility Screen identified my specific imbalances so incredibly accurately that the exercises and mobility work he prescribed have literally given me a new body. Gray Cook is the guru of this stuff, and his approach to strength and mobility is (I think) revolutionary. You can find a FMS certified trainer through his site:
WARNING: many of the apparently minor and "wimpy" kinds of movement patterns FMS prescribes will seem almost pointless and irritating. If you have stability problems or poor mobility, they will break you. Once properly broken, you'll be able to rebuild on top of an incredibly solid foundation.
You don't need to lift heavy weights just because Arthur De Vany or Mark Sisson might have said so. Make the diet specific to your needs as Sisson says in his Primal Blueprint. Another thing which he also says is avoid making stupid mistakes. So if its going to do more harm than good on weak back, I'd leave the weights.
Good posture, if you are going to lift weights, during all your exercises is essential though. If you maintain this all the time, you will not put so much strain on your back, but I suppose you already know this.
Look, I know this book might sound a little far out, but it's author Dr John Sarno has street cred: he's professor of orthopedic medicine at NYU. Of course, that doesn't make him right, but I'll just say that I was in a situation where I thought my lifting career was over, gave his method a serious shot and it cured me. I haven't had any real back problems (nothing more serious than some tightness when I go heavy on deadlifts) in over 4 years since I tried his method. Worst that could happen is that you waste a few bucks on his book. If you get it from the library, you needn't even worry about that.
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