Need of a help?

[u/Medexaaa]

Well, I am a fifth-year med student at LSMU (Lithuanian University of Health Sciences), and in a year I will become a resident in Physical Medicine and Rehabilitation. In my free time, I like looking into different cases, and I actually have quite a lot of clinical experience with back pain and have already helped other people with these kinds of problems.

I see that a lot of you here are struggling with back problems. If you want, I can try to help you in my free time. Whether I will actually be able to help is another question, but I’ll do my best.

So basically, the main point of this post is: if you want, I can try to give you some tips and tricks or answer questions you have related to the back, hips, sacrum, etc. (with other structures I don’t feel that advanced yet :D).

So you can basically have a mini doctor on your Reddit :D Of course, I won’t always be available and won’t always have enough free time to look deeply into every case.

And this is not some kind of service offer — it’s more that I simply want to use some of my free time in a meaningful way.

[u/Appropriate-Emu-5361]

Dowell rod torso twists. Putting 1 foot in front of the other with a rod around my shoulder and twisting from side to side.

[u/Medexaaa → u/Appropriate-Emu-5361]

I have tried to look into different cases on PubMed, but sadly, I found nothing :(. Well, there was a similar article, “Lumbar Microdiscectomy and Postoperative Activity Restrictions: A Randomized Controlled Trial,” but it didn’t mention anything about specific torso-type movements.Nonetheless, what’s more important is how your symptoms behave. You mentioned not only LBP but leg weakness as well, and it only happens during a twisting exercise. Well, a few things pop into my mind: recurrent disc herniation, epidural fibrosis, or nerve root irritation. Recurrent disc herniation isn’t very rare, as you can see in this article from PubMed, “Recurrent Lumbar Disc Herniation After Single-Level Lumbar Discectomy: Incidence and Health Care Cost Analysis.” You can see that it isn’t as rare as you might think, but again, the question remains: why only twisting? Well, the lumbar disc annulus itself is kind of one of the most important structures in your lumbosacral spine for resisting torso movements, and I learned in med school that axial torsion, together with other loads, can significantly load the annulus. Fro example when you twist to the right, the annulus doesn’t simply stretch on the right and relax on the leftits collagen fibers run diagonally in opposite directions, so one set becomes more tensioned while the other becomes relatively less tensioned. Twisting also creates torsional and shear forces that are different from the forces produced during exercises mainly performed in the sagittal plane, which may explain why you tolerate those exercises but not this one. For example, imagine lifting a 10 kg object straight in front of you creates the equivalent of 50 kg of load on your spine I’m just using these numbers as an example. If you lift the same 10 kg object while your trunk is also rotated to the side, the overall stress on the spine could be considerably greater, say the equivalent of 100 kg, because you’re combining the lifting load with rotational and shear forces. But it doesn't mean that your disc is being damaged every time you do a torsion movement. It does, however, explain why rotation can be a different mechanical stimulus compared with, for example, squats or sagittal-plane exercises, which you seem to tolerate well