I didn’t expect to be inundated with emails from people when I posted my back rehab post on Facebook recently. It appears that there are quite a few people out there struggling with a bad back.

Instead of writing to you all and explaining the process I thought it was a lot easier if I gave you a full post on the recovery process I took.

So what happened?

Last summer, I took myself off to the gym for a leg workout. Not long into the session I dropped down into a full back squat and felt my back twinge. Now  I’ll must let you know that my squats go right to the floor, they’re not the squats that people do that  only go to 90 degrees. I knew I’d done something wrong but I was unsure what, I’d never hurt my back liek this before!

Within a few days I'd started to get aches down my left leg and within a week sciatica had kicked in. Half way through the week I had been to see Alison (M10’s resident physio) who suspected the worst. I stuck with the sharp pains for a few more days before booking myself in with a consultant for an MRI scan.

I remember being stood in the Park hospital in Nottingham, frustrated at being kept waiting for over an hour and being in the most pain I have ever been in. I always joked about the numerous times I’ve broken my nose and how painful that is, but this was a whole new level. I wasn’t even given an apology when the consultant opened the door, not a good start! He sat down, looked at my MRI and then said he wanted to operate in 1 week’s time. For those of you out there that are strength coaches or personal trainers, you know what that was like to hear!! I felt like I’d been shot!! He didn’t ask my any questions about my career, I was just another case in his eyes! What he didn’t realise was that the hour wait and the unprofessionalism he showed made, had just me even more determined to not have the operation.

I came home, feeling very flat at the thought of all my hard work in the gym being undone by going under the knife. I called some colleagues to ask their thoughts and then I made up my mind, I can fix this! That was it, I was going to use all the knowledge I have and colleagues I have met along the way to help me try and fix this myself.

The next morning, I took myself back to the gym and just had a strong word with myself. “What would you do here Mark? “ “If this was a client in the same situation, take a step back and write the ideal program for yourself”.

When a new client walks in the gym here I want to know case history, previous injuries etc. I’m very thorough with the process that I use and over the years I have designed a comprehensive testing system which has been created from my education and also from adding what works and eliminating what doesn’t.

I knew I was going to need some more help so I consulted an osteopath who lives near to me, I booked in with Alison for regular physiotherapy appointments and I also booked in with a sports massage therapist once a week. Once these were in place I knew they would be able to give me weekly feedback on my progress and I would adjust the program I had written accordingly.

The rehab

The early stages of my rehab were hard as my range of movement in my hamstrings was about 10 degrees before the pain set in. So if that was all I had, that’s where I was going to start.

My first program objectives revolved around restoring as much flexibility as I could, being able to walk pain free again, foam rolling daily to break down my tight fascia and to restore my glutes that had decided to switch off and wasted!

I know there are certain coaches that don’t isolate the glutes, but I’m a big believer in making sure they fire correctly before I progress. Even more so since my injury! In my facility I have left them out in the past, to find them creeping back into my all programs. The reason for this is because they work! Exercises like single leg glute bridges really helped get me back to split squatting and being pain free.

My next step was to work on my imbalances and these stemmed from an old ankle injury back from my rugby days. When I walked I wasn’t getting correct dorsi flexion(ankle movement) in the right ankle,  as a result my right hip wasn’t extending properly and my hip was constantly tight. I knew this was a problem but I’d never fixed myself (note to you guys, if you have a niggle and your training through it, STOP NOW and fix it!)!! I’m glad I spent 2 years studying biomechanics from the Gray institute in America as my knowledge of the hip and ankle allowed me to figure this out for myself.

With some help from Alison we set about mobilising my ankle/hip and then started stabilising it in the gym. I combined this with regular massage to a very tight piriformis in my left glute and within 10 days the pain had started to lift and I was walking with a lot more ease.

I’ll also let you know that at this stage I could only manage 20 seconds on a plank (on my knees) and 15 seconds for each side on a lateral plank (again on my knees). We use these exercises as key markers for core/back health in our testing system and they come from the work of Stuart McGill. Predictors for back health are 2 minutes for the plank and 75 seconds for the lateral plank. The other one that I couldn’t do at that stage was 2 minutes for a horizontal back extension (isometric hold).

With all this “low level” rehab work I was still determined to lift weights, so when sitting became easier I added an upper body workout and cut out all over head pressing and bent over work. Even some arm work was uncomfortable but I managed to get a good workout in place! That at least helped my upper body hold onto some muscle mass and stopped me going insane!!

With the combination of the above I managed to get into a condition where I could at least attend an internship with Charles Poliquin in Sweden, I didn’t do much on my legs when I was training there but getting there was an intermediate goal for me.

When I got back I put together a lower body program that involved a lot of unilateral exercises like split squats, single leg RDLs, step ups and what soon turned into the saviour, the seated good morning. Within a week of starting the seated good mornings my pain subsided by another 25% and continued to improve as I progressed the exercise to standing. The weight I was using at this stage wasn’t even 20kg but soon increased!

Over the course of the rehab process I visited Heather Pearson, she’s an ART (Active Release technique) practitioner based in London. Her treatment provided me with huge release and also enabled me to push on with my training. Heather is also a strength coach, her knowledge of where I wanted to get to helped us work together.

Over the months ahead I literally stuck to unilateral exercises (1 leg or arm at a time), strengthened my posterior chain (the glutes, lower back and hamstrings) and progressively lifted heavier weights through my use of structured programs. When I was happy that I had fully restored my imbalances (which was only recently), I progressed to bilateral exercises like squatting and deadlifting.

Quite a few of you have asked what parts of my education have been the most valuable throughout the process. I used a huge amount of my knowledge gained from my PICP certifications/internships with the Poliquin Institute. I think without the strength and conditioning back ground I have, I would have stopped making as much progress. All the biomechanics knowledge, assessment skills, soft tissue, ART, physiotherapy have all been invaluable but I certainly feel that getting stronger has played a huge part in my recovery to the level I am today. Don’t stop at flexibility and stability like so many people do, you must get strong.

It’s been a long journey, I’ve learnt a lot and I certainly wouldn’t like to do it again. I certainly now know firsthand what’s it’s like to rehab a back and I’m glad to say that it was without surgery.