Lumbar Disc Injury from Straight Leg Deadlifts

Posted On: June 22, 2017

This is the sixteenth case review from my past practice. I am Dr. David Johnson a chiropractor and physical therapist in Highland Park and Lake Bluff. I am the director of North Shore Spinal and Sports Rehabilitation. I started as a chiropractor in Lake Forest, Il in 1988. I integrated physical therapy into my practice in 1990.

This is a case where a woman in her forties injured her lower back doing straight leg dead lifts with her personal trainer. She came to me with a full-blown sciatic problem. It hurt when she sat or bent forward at the waist. The only thing that gave her relief was standing. She was taking an anti-inflammatory and a muscle relaxant.

Review of systems was normal with no loss of bowel or bladder control or saddle anesthesia.

I worked her up. When I had her flex her spine she got referral down the right lower extremity. Bending her spine back into extension was limited but only caused local lower back pain. Side bending was painful in either direction. Neurological evaluation revealed a positive straight leg raise response on the right. She had slight decrease sensation to pinprick on the outside of her right foot. There was no strength loss. Babinski’s was down going bilaterally.

Given her neurologic involvement I ordered a lumbar MRI. Which revealed an L5/S1 disc herniation.

I started her with extension-orientated therapy with exercises popularized by McKenzie. At first she did press ups combined with interferential electric simulation. As she responded she was progressed into spinal stabilization exercises. I also started to manipulate her spine. In a relatively short period (2 months) she was ready to return to working out.

I started her off with upright aerobic conditioning (stair-master, elliptical etc.) and I had her continue with her press-ups and spinal stabilization exercises. She also continued to get adjusted. After another month she was ready to integrate back into weight training. I sent her back to the trainer but I asked that he avoid straight leg dead lifts.

The personal trainer was furious. He bad mouthed me to the patient and raised a big fuss. The good news is the patient went on with a different personal trainer and continued to flourish.