Back injuries – an athlete’s worst nightmare. So much of human movement relies on the ability to both stabilize and fluidly move your spine. What happens if you herniate a disc? You might be wondering, can I ever lift weights again? The short answer is yes, but first let’s discuss what a herniated disc is, and then address how you can safely incorporate strength training back into your workout program.

What Is A Herniated Disc?

Herniated-Disc

Disc herniations of the lumbar spine (L3-L4, L4-L5, L5-S1) are one of the more common back injuries. Between each vertebra in your spine is a vertebral disc. These vertebral discs serve as cushions between the vertebrae, and they help to absorb impact while also assisting the spinal facet joints to guide movement in the spine. Unfortunately, these discs can rupture and herniate. In some cases this can lead to pain and pressure on your nerves, and also cause symptoms in your back that can radiate down into your legs.

What Causes A Herniated Disc?

While symptoms can come on suddenly and acutely, disc pathology is usually considered a long-term chronic condition. The last aggravating motion that caused the acute bout of pain is often just the final movement of several times your back was stressed by poor movement mechanics. This is why lifting weights with proper form during all exercises is essential. Poor movement mechanics themselves are often not painful, but the repetition of poor movement (especially with heavy weights) can lead to micro-trauma in the spine that cumulatively adds up and result in injury.

Poor-Lifting-Form

Degenerative disc disease and herniations are associated with increased lumbar spine mobility, particularly excessive flexion and rotation. In other words, the more your spine moves out of its neutral position during exercise, the greater risk you’re at for experiencing a disc problem 1 2.

Disc Herniation Symptoms

Symptoms may vary slightly, but generally consist of pain or decreased sensation in the back, buttocks, thigh, and calf. People may also have some numbness or tingling, in addition to muscle weakness, in the body part served by the affected nerves.

If you do experience weakness, it is generally recommended that you see a health practitioner. Your health practitioner should be able to tell which segment of your spine is most likely affected based on the exact location of your symptoms.

Tests To Identify A Lumbar Disc Problem

In addition to noting where your symptoms are, your health practitioner should also perform:

1. A full neurological examination, which includes a screen of isolated muscles, sensations, and reflexes.

2. Nerve tension tests, usually a straight leg raise test or the crossed straight leg raise test.

Only if your health practitioner is not able to identify what is going on, would I recommend imaging tests such as MRI. While MRIs can be helpful, keep in mind that they are expensive, and often unnecessary in treating disc herniations.

How to Start Lifting Weights Again After A Herniated Disc

Fortunately, the best thing you can do to improve your herniated disc is to exercise!

Exercise is not only recommended, it’s required to help retrain the muscles in your back.3 More specifically, spinal stabilization exercises help more than a general exercise program.4

The exercises you perform will depend on how you feel and how long it’s been since you’ve injured your back. Here’s a 3-phase breakdown of how to reincorporate strength training after herniating a disc.

Prior to Exercise – Control the Pain

Prior to exercising, you’ll want to minimize the pain that you experience. For most people with herniated discs, lightly extending the back can help to reposition the discs anteriorly.

Try laying prone on your elbows to see if it alleviates your pain (like sphinx pose in yoga). It’s important to relax and breathe normally. If this position feels good, you can even straighten your arms into the prone press up (arms straight, back relaxed and curved).

At this stage, consider modalities (such as electrical stimulation) and only very light movements to maintain blood flow and to control pain. Returning to light activity can actually speed up your recovery, since light loads can speed up the early healing process. That being said, you must be careful not to push yourself to hard too soon. Heavy loads have been shown to have the opposite effect, decreasing blood flow in the spine and possibly impairing proteoglycan synthesis, which is critical for the normal function of your discs.

Start with walking, and gradually incorporate the following exercises in phase order.

Phase 1: Acute Inflammatory Phase

This phase is usually started in the first 2 weeks, after local back pain is controlled and minimized. At this point, your pain should not get worse with any of these exercises. The focus here is to begin reloading your spine with light activity, and to relearn how to move properly. When your body experiences pain, your proprioceptive abilities are decreased (meaning you have less control of your body position than normal).

The following exercises focus on keeping your spine in a neutral position at all times. The focus is movement reeducation and core stability.

Exercise #1: Deadbug

Keep the small, neutral curve of your back (you may place a small folded towel underneath your low-back to help you feel and maintain this position). Practice lifting your legs off the floor while maintaining complete stability of your spine. Your low-back especially should not lift away from the towel. You should feel your abdominals engage and tighten to prevent your pelvis from moving. Progress to the full movement, extending one arm and the opposite leg.

Hold for 5 seconds, and then switch sides. Start with 3 sets of 30s. Work up to performing deadbug for 2 minutes straight.

Exercise #2: Bird Dog

Similar to the deadbug exercise, bird dog involves extending one arm and the opposite leg without moving your spine or rotating your hips. Lifting opposite arm and leg off the ground while maintaining your balance will challenge and stimulate the diagonally-oriented muscles (multifidus, rotatores), which is exactly what you want when recovering from a herniated disc.

You should be able to perform this exercise without any movement of your spine. Try this with a foam roller (or rolled up towel) balanced on your back. You’ll know you’ve “cheated” if the roller or towel falls off your back. Try to hold your balance on each side for 5 seconds before switching, and perform for 2 min straight.

Exercise #3: Hip Hinge

Especially if you want to return to weight lifting, it’s imperative that you practice moving and bending from your hips without movement in your lumbar spine. If you’re not sure if you’re keeping your spine neutral, try putting a piece of tape along your low back or holding a dowel against your head, upper back, and tailbone.

When standing straight up, you should have a slight curve in your low-back. If you bend your back at all while doing the hip hinge, you’ll either feel the tape pull or lose the dowel from one of these three points of contact. Your goal, especially when you lift weights, is to move from your hips, and not from your spine.

First, perform the hip hinge in the quadruped position. Once you’ve mastered that, do a standing hip hinge.

It’s critical that you understand how to move from your hips while stabilizing your spine before returning to bodyweight (or loaded) squats, deadlifts, and rows.

Phase 2: Basic Stabilization & Repair Phase

This phase will last about 2 to 4 weeks, and your focus in on movement control and spinal stability using anti-rotation exercises.

At this point, your body is in what we call the “repair phase”. As it’s healing, you’ll want to increase the challenge to the diagonally-oriented muscles in your spine (external & internal obliques and multifidus, all in combination with the transverse abdominus). Here, you will start to add weight to challenge your stability.

Exercise #4: Side Planks

This is a great core exercise to incorporate early on as it challenges your obliques without excessively compressing the spine.

First, perform side plank with your knees bent prior. Progress to straight legs. Hold side plank for 10 seconds, with only 3 seconds of rest, for a total of 10 reps. As you get stronger, start combining the holds until you can do this for 100 seconds straight on each side.

Exercise #5: Push-Pull Exercise (aka Paloff Press)

This helps to challenge the rotational stability of your spine. You’ll need a cable or elastic tubing for resistance.

Start with holding the cable at your stomach. Stand tall with your core tight. As you push your arms straight out in front of you, you’ll feel the resistance try to pull you sideways. Maintain control and resist the side pull, keeping your hips and shoulders square. Hold for 5 seconds, and then slowly bring your hands back towards your stomach. Repeat 10x. Once this gets easier, increase the tension by standing farther away, using a stronger resistance band, or increasing the weight.

Bonus Tip: You can change the height of the anchor point to emphasize the challenge on your anterior muscles (abdominals), or your back muscles. If you want to challenge the abdominals more, place the anchor point around shoulder-height. If you want to challenge your back more, place the anchor height below your pelvis.

Exercise #6: Unilateral Press & Unilateral Row

The second half of this phase involves performing many of your normal exercises, but on one side at a time. Perform lighter loads of your traditional exercise routine, and modify to do them unilaterally.

Incorporate these two common exercises, but perform them on one hand at a time. You should feel parts of your trunk (your core and spinal stabilizers) engage differently (and more) than if you were to do these exercises with both arms simultaneously.

Phase 3: Strengthening and Rotation

At this point, there should be no pain. You’ve spent the last few weeks strengthening your core so that your trunk can maintain stability and resist rotation and flexion under load. The last step before returning to sports training and higher-level movements is to train your spine to rotate without flexing or extending.

Exercise #7 – Chops & Lifts

Now you’re going to rotate your spine while maintaining core control. First, perform chops and lifts focusing only on rotation through your spine. Then, make these exercises more full-body by pivoting and rotating your feet and hips as well. Just as in the push-pull exercise, you can change the anchor point to challenge different parts of your core. Make sure to not flex or extend your spine.

If you follow this 3-phase approach, you’ll train your body to be stronger, more stable, and more injury-resistant. You’ll allow the disc to heal and retrain the surrounding muscles to protect it. A disc herniation doesn’t have derail your strength and fitness goals. With strategic training, you can return to weight lifting like deadlifts, squats, and kettlebell swings, probably with better form and control than before.

Show 4 References

  1. Adams MA, Hutton WC.Prolapsed intervertebral disc. A hyperflexion injury 1981 volvo award in basic science.Spine (Phila Pa 1976). 1982;7(3):184–191
  2. Marshall LW, McGill SM.The role of axial torque in disc herniation.Clin Biomech. 2010;25:6–9
  3. Hides, Julie A.; Richardson, Carolyn A.; Jull, Gwendolen A. Multifidus Muscle Recovery Is Not Automatic After Resolution of Acute, First?Episode Low Back Pain1 December 1996 – Volume 21 – Issue 23 – p 2763–2769
  4. Ye C, Ren J, Zhang J, Wang C, Liu Z, Li F, Sun T. Comparison of lumbar spine stabilization exercise versus general exercise in young male patients with lumbardisc herniation after 1 year of follow-up. Int J Clin Exp Med. 2015 Jun 15;8(6):9869-75. eCollection 2015.
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25 Comments

  1. profile avatar
    Marc Perry, CSCS, CPT Apr 25, 2016 - 15:29 #

    Another awesome article, Kenny. So much sound, actionable advice in this article. Well done.

  2. profile avatar
    Amanda Apr 29, 2016 - 12:33 #

    I literally just herniated a disc last Friday, so the timing of this article couldn’t have been better for me. Thank you! I had just finished some deadlifts at light weight and about 20 minutes after a surge of pain emerged from my lower back. I was beside myself trying to figure out what it had been, since I hadn’t been doing any heavy lifting, so I suspected it was an overuse [and possibly a loss of form] issue. All of this was really helpful!

  3. profile avatar
    Ken Apr 29, 2016 - 12:39 #

    Wow! This article was made for me. Thanks a million.

  4. profile avatar
    Maria Apr 29, 2016 - 23:55 #

    While I find the first half of the article very informative and well explained I miss seeing more exercises that help to correct faulty movement patterns. Having gone through the whole experience of a herniated disc myself and trained several clients with back pain I find that unilateral exercises like exercises #4,#5,#6 should come much later. Why not first start with a regular bent over row rather than going straight into the unilateral one. But all very well presented and nice video clips.

    1. profile avatar
      Kenneth Leung, DPT May 07, 2016 - 00:32 #

      Maria, I’m glad you thought the first half was informative. As far as the exercises are concerned, in no way was this meant to be a comprehensive list. To keep things brief, my focus was to give an understanding of why certain exercises may help. I agree with you that a bilateral row should be able to be performed prior to trying a unilateral row. However, there is an increased benefit with unilateral rows over bilateral, so as soon as someone has the strength and stability to perform the exercise unilaterally, my preference is to mix that in as it will help to bias the deep stabilizers (multifidus, rotatores, obliques, etc) more.

  5. profile avatar
    SURESH Apr 30, 2016 - 03:07 #

    Excellent Perry, The rehabilitation exercises are boon to people suffering from Back disk problems. Do you have any similar exercises suitable for S.I.Joint ( Sacroiliac joint) ligament strain problem occurred during excessive stretching.

    1. profile avatar
      Kenneth Leung, DPT May 07, 2016 - 00:29 #

      This would really depend on which SI ligaments are being strained. The inominate (pelvic bone) can be rotated forward, backward, flared in or out, shifted up or down as well as the sacrum being out of alignment. Generally, doing core stability exercises which contract and stabilize the lumbar spine and the SIJ will help

  6. profile avatar
    Matthew Kilbourn May 06, 2016 - 10:30 #

    Kenneth, this article is fantastic! I have suffered from disc issues since I was 16, and wound up having an L4-L5 microdiscectomy at 19 to remove disc material that had slid down my spinal column and created an awful impingement. I thank God for that surgery. I appreciate how this builds up through the three planes of motion. I have tried a lot of different PT approaches and exercise routines, but I feel strongly that this is by far the best approach I have ever seen. If you wind up reading this and care to comment, I wonder what you would say to light ankle weights for load progression on the dead bugs and bird dogs, or if you would shy away from loading with those exercises. Thank you so much for sharing this knowledge and posting this for people like me!

    1. profile avatar
      Kenneth Leung, DPT May 07, 2016 - 00:27 #

      Matthew, I’m glad this article helped. There are several ways to progress or regress each of these exercises, and increasing the load (ankle weights) is one of them. As long as you keep your form optimal, it’s safe to add weights. If your goal is strength than do this. If you goal is “stability”, another way to progress the exercise is to make your base of support less stable (you can do the deadbug on a foam roller, or do the bird dog with the knees next to each other and the hands next to each other)

  7. profile avatar
    Diego Cervera Oct 27, 2016 - 15:31 #

    Hi Kenneth. I have a cervical herniated disc (C6 – C7) and a lumbar (L5-S1) Do you think that all these excercises applies to my case too? thanks! I currently don’t have pain. Only some minor ones on the left side on the plates.

  8. profile avatar
    Kenneth Leung, DPT Oct 27, 2016 - 23:59 #

    Hello Diego. Yes, these exercises would still apply to you, especially if you have a lumbar disc herniation. Now, if you have an “end-plate” issue, that is a bit different, so you may need to clarify what you mean by “on the plates”. Either way, keep your low back in a neutral position. As for your cervical herniation, there are other exercises and cues that I would use. The exercises listed here are for people with lumbar disc pathologies. If you have no pain in the neck/shoulders/arms when doing these exercises, you should be safe!

  9. profile avatar
    Olivene Clavon Nov 02, 2016 - 12:43 #

    Excellant article. Question: I have access to a gym on the grounds of my apartment complex, but no free weights. What type of gym equipment would be most useful in the place of free weights. There are treadmills, ecliptical, and several other types of weight machines to use. I would like to build muscle and gain weight. I am 5’6″ and weigh 114 lbs.

    1. profile avatar
      Kristin Rooke, CPT Nov 03, 2016 - 14:38 #

      Hi Olivene,
      While we advocate full-body workouts using free weights, you can definitely get a good workout using the equipment at your gym. If you combine machine exercises with bodyweight exercises, you’ll still be able to get the benefits of functional training. I don’t know what equipment you specifically have, but I can recommend some great bodyweight exercises to do. Squats, lunges, push ups, pull ups, planks, and plyometrics are just a few of the exercises you can do to get a great workout. If you want some specific workout ideas, check out these plyometric workouts and this bodyweight circuit workout to lose fat. Hope that helps! Let us know how it goes.
      -Kristin, BuiltLean Coach & Managing Editor

  10. profile avatar
    Aion Kane Nov 11, 2016 - 14:48 #

    A timely article. I’ve had my disc herniation for a few years now and has been alleviated by doing Yoga. Recently, I’ve gone into strength training and now can deadlift. I’m 5’7″, 180lbs and can deadlift (with 6 inch elevation) about twice my weight. Improper form leads me to back pain for a couple of days. Yoga helps in the relief. Until I read the article, my goal on the deadlift was 500lbs. I guess I better limit my lifts to just a little over my body weight, just to help keep my strength up.

    1. profile avatar
      Kristin Rooke, CPT Nov 12, 2016 - 11:33 #

      Hi Aion,

      Really sorry to hear that you’re dealing with a disc herniation, but it’s great that you’ve found relief through yoga and are able to manage your symptoms. Marc has also experienced disc issues, and now practices yoga at least 5x per week because of how much it improves his flexibility, movement quality, and pain management. Having a performance goal is great, and while you might not be able to focus on deadlifting 500-lbs right now, you might want to consider setting another goal – for example, performing a specific number (or type) of pull ups, improving your squat form & technique, or learning how to train with kettlebells. Keep us posted on your progress!

      -Kristin, BuiltLean Coach & Managing Editor

  11. profile avatar
    Constantin Ivanov Nov 22, 2016 - 10:44 #

    Hey, that’s a great article! Very helpful.
    I just herniated l4-l5 and I’m dealing with the tingling in the foot and some stiffness in the back. I know people that managed to rehabilitate their backs and lift heavy again but I have another question. Do discs really heal or just become asymptomatic with time and shrinking process. I’ve read that in some cases they repair themselves, not completely of course but to some extent. What’s your opinion on this matter?

    1. profile avatar
      Kenneth Leung, DPT Nov 23, 2016 - 02:21 #

      HI Constantin. That’s a great question. One of the big conundrums with back pain/disc issues is that the pain isn’t always correlated with what we see on the MRI. You will hear storied of people having intense sciatic pain without an obvious herniation, and of others without any reports of pain but with horrible looking MRIs. Also, people have reported decreased pain months later while their MRI demonstrates minimal change. That being said, the amount of disc herniation definitely improves, and the annulus (the tissue that holds the disc in) also scars down and heals. Most importantly, the muscles around the spine must be retrained to ensure proper function. Hope that helps!

  12. profile avatar
    Ramzi Nov 22, 2016 - 22:58 #

    Hello! Just a question. I have a mild disc bulge and I am currently working with a certified trainer. I just wanted to ask if it is normal to feel numbness in my leg but NO pain in my back? I would just like to know if I am treating it well or making it worse its an L5 mild bulge again.

    Thanks

    1. profile avatar
      Kenneth Leung, DPT Nov 25, 2016 - 21:57 #

      Hi Ramzi. Yes, it is not abnormal to feel numbness without pain. The fact that you have numbness however indicates that your nerve is involved somewhere, so still be extra careful with any of your core exercises. Focus on stability exercises, hamstring and upper back flexibility, and of course, avoid anything that makes your symptoms worse.

  13. profile avatar
    Victor Nov 26, 2016 - 17:01 #

    Hi Kenny, thanks a lot for the article. I got a herniated disk a couple of years back and had quite a few recurrences (some of them truly terrible). I am fine now and work out, and would like to go back to pulling sumo (which is what my LB hates) – everything else is fine (other than ATG squats). Do you have any advice on how I could move in that direction as would love to pull again? I would like to take it up again, but know my LB isn’t 100%Many thanks,

    1. profile avatar
      Kenneth Leung, DPT Dec 06, 2016 - 01:59 #

      It’s a risk vs reward argument for you. When you participate in activities that you enjoy that put your back in a compromised position, you inherently take that risk. What you can do is build up the strength of your back stabilizers which will help your body and your spine tolerate the forces that sumo and other activities may cause. Generally, I would recommend people to build up their backs to be at least 20-50%stronger than what they were like PRIOR to being injured. Otherwise, you’ll likely get hurt again and need to spend even more time away from the sports and activities that you want to do.

  14. profile avatar
    Rizwan Rahman Dec 03, 2016 - 14:33 #

    Dear Kenneth,
    Your article actually gives a lot of hope to people especially when all we hear is that we’all suffer with a slip disc for the rest of our lives. Would like to get in touch with you through email and discuss further details about my condition and take advice accordingly. Hoping to hear from you soon.

    1. profile avatar
      Kenneth Leung, DPT Dec 06, 2016 - 02:00 #

      Hi Rizwan. If you would like a consultation, I’d be more than happy to help if you are in the area. I can be found at UCSF, either at our Orthopedics building, or across the street at our Health and Wellness center.

  15. profile avatar
    Marti Jan 27, 2017 - 13:43 #

    Forgive me if this was addressed in the comments section but I have two herniated discs in the cervical region along with a bone spur. I am a 49 yr. old woman and I have been avoiding lifting because I was afraid it would aggrevate the discs and cause more arm pain. Advice for me?

    1. profile avatar
      Marc Perry, CSCS, CPT Jan 27, 2017 - 20:02 #

      Hi Marti – see a doctor / physical therapist (ideally a physical therapist who is very fit him/herself), and see what they recommend. You have a medical condition, so it’s outside my scope of practice to give you any recommendations. Always keep hope!

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