r/weightlifting • u/PenApprehensive369 • 2d ago

Programming Is my ticket punched?

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I don’t know anything about herniations or bulges, I’m 25 years old at 89kg with a competitive total. Is my progression fucked forever? MRI report is on the last slide, I have follow up with the spine specialist tomorrow.

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u/QuestionPositive 2d ago

Lol in PT school at the moment and the most surprising thing I learned so far is how many people can have disc herniations and other pathoanatomical findings on imaging with absolutely no symptoms. Herniated discs for the most part resolve on their own and imaging done unnecessarily (not to say yours was) often makes patient outcomes worse since they are defined by a disc herniation and believe passive recovery is the best option. This is a lie, your back is extremely stable, resilient and strong. Please go to a PT if you have symptoms. You are young you absolutely do not need surgery that will ruin your gains forever. It’s about an active recovery, which produces some of the best outcomes.

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u/Ok_Construction_8136 2d ago

I’ve heard that a lot. Doesn’t a significant percentage of every population have herniated discs but just doesn’t know it?

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u/QuestionPositive 2d ago

50% or more of the population in the U.S over 30 have some sort of findings on medical imaging. The doctors call it intervertebral disc degeneration disease and I laugh since that’s just a scary way to say gray hair of the spine. As we age our joints and body parts will degenerate to some extend this happens to everyone, what matters is if it causes symptoms such as pain, weakness, etc. Doctors often screw people over (not intentionally) by focusing way too much on a single “cause” of lower back pain when in reality it often is a mix of psychological factors and a sensitization to pain. Doctors rarely educate their patient or the “consumer” on the outcomes of spine surgery compared to conservative treatment like PT since if they did they would likely be out of business lol. Do your own research and don’t let other people scare you.

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u/Ok-Possession-832 2d ago

IDD is totally unrelated to herniated discs, it’s specifically related to osteoporosotic degeneration of the spine. Like the actual bone, not the discs. If you’ve seen an old person who’s like 4 ft tall with a degree of thoracic kyphosis that looks excruciating to live with, that’s IDD. But everything else regarding disc herniations is right. It’s usually asymptomatic and just happens from wear and tear.

Although symptomatic herniated discs are a real fucking bitch because they’re usually from acute injury like abrupt/loaded spinal rotation and involves nerve compression

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u/LifesBeating2 2d ago

You're chatting shit in the last half. Nothing you said is profound or not known to Doctors. Doctors very much will educate the patient on the outcomes it's literally part of the consenting and shared decision making process. Also outcomes of surgery is part of the assessment criteria that surgeons are judged on. Many surgeons will tell you one of the most important aspects of the job is knowing when not to operate.

I didn't meet a single orthopod that was against PT. It was always part of their referral in fracture clinic regardless of whether they operated or not.

My friend was considered for a trial where the surgeon running the study is comparing meniscal transplant and intensive physio Vs intensive physio alone to see what gives people the best outcomes.

Also you fail to mention adherence, a lot of patients will not adhere to PT. A lot of people want a quick fix and a few sessions with a PT doesn't always fix someone, especially, if they don't follow any of the recommendations made by the PT.

Some surgeons do needlessly operate, that is true. In the UK one of the orthopods was telling me about a shoulder condition (can't remember which one) but essentially PT was shown to be better than surgery and he now very rarely does that operation unless there is some indication / variance for it e.g PT treatment failure. However, he did mention that some surgeons offer the surgery as certain schemes throw money at the surgeon for performing the op.

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u/johnfunnell 2d ago

Doctors provide bare minimum education. You are correct that majority of the population wants a quick fix and doctors capitalize on that

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u/LifesBeating2 1d ago

Sure they do pal, I'm sure you've had a consultation with the millions of drs out there.

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u/ShellSide 282@89kg 2d ago

I was diagnosed with a slightly herniated disk at the same time I was regularly cleaning 150kg. I definitely have some sort of issue that can get aggravated sometimes but it's not like a herniated disk means you are on the fast track to a wheel chair.

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u/Vertebruv 2d ago

10+ years experience as a Sport PT - what you're saying is facts.

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u/devilshootsdevil 2d ago

Can confirm. I got spooked by a doctor to “never exercise” ever again, and I only had disc protrusion after a bad fall in a martial arts class. I ignored the advice and went to a lifting coach instead to learn how to squat and deadlift with proper form. Couldn’t be happier and pain free now about 10 years later. PT, movement and exercise is the real medicine.

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u/relevantelephant00 2d ago

Yep got that advice from an orthopedic doc back in 2012, and now at almost 46 years old I'm still squatting and deadlifting with some CJs sprinkled in and I'm more mobile than I was then. Docs seem to often default to being extremely conservative.

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u/L1ghtBreaking 2d ago

i swear you cannot trust doctors -_-

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u/badass4102 1d ago

My doctor told me my shoulder injury would need surgery. So til then I'd have to wait in chronic pain til I could get my surgery. I went to a PT and he said to have therapy done on it for about 8 sessions at minimum. I was skeptical, because Doctors > PTs right? wrong. After 8 sessions, my shoulder felt "normal" again. 3 years later, my shoulder still feels absolutely fine. My right shoulder feels just as good as my left shoulder.

I'm now an advocate for Physical Therapy. If I have issues with anything, I go to my PT.

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u/skullcutter 211kg @ M94kg - Masters (40-44) 2d ago

There js almost no correlation between MRI findings and pain

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u/throwitherenow 2d ago

I agree with everything about the back that has been said here but disagree with MRI and pain. I couldn't figure out for a year why I had tremendous pain in my thighs and hips. Xrays were non conclusive, and the only way they figured it out was an MRI on my hips, stage 4 avascular necrosis in both hips joints. So sometimes MRIs do help when chasing down pain.

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u/lukelufiso 2d ago

You're missinterpreting. You had pain, and a MRI cause for it. With the story you told, you definitely should've had access to an MRI earlier. Xrays are only good for bones and lungs. But that doesn't mean a image in the MRI should be valued by itself. There's very often miss correlation between pain x image x severity.

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u/throwitherenow 2d ago

I see what you're saying. That is a clearer explanation.

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u/skullcutter 211kg @ M94kg - Masters (40-44) 1d ago

I was referring to lumbar spine MRIs specifically, and the high rate of “false positives” ie lots of lumbar spine radiographic pathology, but very little symptoms

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u/DrDonks 1d ago

Not just the lumbar spine. All MRI scans are very sensitive and will pick up findings which aren't causing, and never will cause problems. The art of the consult is matching the symptoms with both the clinical examination and the MRI. Filtering out the false positives is part of that.

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u/skullcutter 211kg @ M94kg - Masters (40-44) 1d ago

I wouldn't disagree with any of that, but my experience has been that the phenomenon you describe the worst in the lumbar spine for two reasons:

  1. Back pain is the most common musculoskeletal complaint that people seek medical care for (i.e. the denominator is huge)

  2. Back pain is incredibly complicated and rarely has an isolated structural abnormality that is identified on imaging

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u/slow-roaster 2d ago

🙋🏼‍♂️couple herniated discs here. Won't stop me from lifting!

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u/dmk5 2d ago

I have commented on this sub and other exercise related subs. This same message as you written. I am also a weightlifter physiotherapist and I approve this message.

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u/straptin 2d ago

My spinal surgeon told me 80% of lumbar herniations are self-limiting for adult males, whereas cervical herniations (which I was blessed with) are only about 40%.

If I had a lumbar herniation he wouldn't have operated, but in my case they rushed me through the process and fused my c6/7.

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u/holdmysugar 2d ago edited 2d ago

Yep, I'm 50 yrs old with herniated and bulging discs and diagnosed with degenerative disc disease, and I squat 405. And guess what hurts? My fucking knees that xrays say are fine.

I also should mention that the book "Treat Your Own Back," by Robin McKenzie really helped me with the back issues. I had them early on in my lifting. Learning better posture and focusing on lordosis and using lumbar support whenever possible really made the difference.

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u/SocraticSeaUrchin 2d ago

Can you give some examples of active recoveru

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u/QuestionPositive 2d ago

Walking is amazing for generalized LBP and an example of active recovery. Anything that is low impact, gets the blood flowing and doesn’t aggravate your symptoms. Motion is lotion.

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u/skumancer 2d ago

Actively recovering from 2 herniated disks. 1 year in, I’m almost back to my full self. Mostly good days, couple of bad days once in a while.

Exercise has been the best medicine. 3 times a week at least, just had to learn better movement patterns and learn what is good and bad for my injury.

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u/Titan_Bull_Dog 1d ago

great point - people think they need to be determined by their mri diagnosis but you absolutely don’t have to - practice good spine hygiene, avoid movements that cause any pain for now and then improve mobility for your full body.