Exercises for herniated intervertebral discs

Author: Alexander Shishkin coach at the Bubnovsky center and gym.
2011-02-12

An intervertebral hernia is a deformation of the intervertebral disc with a bulging of more than 3–4 mm. There are several types of hernias: front, lateral, sequestered, Schmorl's hernias, and (the most dangerous) paramedial hernias. As mentioned earlier, the greatest danger for both athletes and non-athletic individuals is posed by paramedial hernias, as they are directed towards the root of the spinal cord and can compress it, causing the so-called "root syndrome." This violation of the integrity of intervertebral discs can be triggered by various factors: poor nutrition, a sedentary lifestyle, and improper training.

It is important to note that intervertebral discs, just like the vertebrae themselves, do not have nerve endings or receptors. Therefore, they cannot cause pain sensations. The pain that a person experiences with this pathology is most often caused by the spasm of the stabilizing muscles of the spine (the deep back muscles). For example, muscles such as the short and long rotator muscles and the multifidus muscle. These muscles go into spasm because, as a result of the disease, the stability of the vertebral segments is compromised. Consequently, the muscles must perform their compensatory function to a greater extent than usual, leading to fatigue and spasms.

In this case, the main task of training and treating a hernia/protrusion is to relieve the muscle spasm and train it to handle the load. This can take several months. The training should include several different exercises targeting the problem area, using moderate weights for 12-20 repetitions per set. After the session, it is advisable to stretch the worked area.

The range of exercises for this pathology depends on many factors, such as age, gender, physical condition, and the psychological characteristics of the patient. It is especially difficult to relieve pain in trained individuals, as a well-developed muscle corset does not allow access to deep muscles (trigger zones). We must understand that exercises with axial loads can become an exacerbating factor.

Therefore, the main principle when exercising with a hernia or protrusion is the complete exclusion of axial loads on the spine (such as squats with a barbell on the shoulders or deadlifts), as well as exercises that provoke acute pain. In addition to such treatments for a hernia as massage and stretching, it is advisable to perform the following exercises:

1. Exercises for the abs, for example:

It is recommended to perform with maximum amplitude for better stretching of the back muscles.

2. Inclines over a pommel horse (hyperextensions)

3. Various pull-ups

4. Pulldowns from the upper horizontal block

When performing horizontal block pulls, you can lean forward for better stretching of the back muscles. However, the lean should be done with a straight back and tilted head, which will better stretch the lumbar muscles.

5. Bench presses

Additionally, as much as possible, avoid prolonged static positions (sitting or standing) in daily life, as static work of the back muscles provokes spasms.

6. Exercises for the arms and shoulders can be done without restrictions, except for axial load exercises:

7. Exercises such as:

It is better to perform them sitting with back support at an angle of 70–80 degrees.

All strength exercises for a hernia should be performed with special caution, as in some cases they may lead to even greater spasms.

In my practice, many active professional athletes with intervertebral hernias do not experience pain due to their well-developed musculature. This is even true for veteran athletes. If you are engaged in one of the strength sports, make sure to practice regularly, without long breaks, and do it correctly; this will help you avoid health problems and will contribute (as much as possible) to the treatment of a hernia or protrusion.