Lower back pain - what to do next

Had that happen 2 weeks ago and here's what I did:

Iced it every 3 hours, 15-20 minutes at a time for the first 72 hours.

Laid off any exercise that put pressure in the lower back. Focused on arms, chest, shoulders, upper back.

I have full range of motion back and the pain is gone but I'm not poking the bear for another 2 weeks.

Sounds like you just kept aggravating a strain. Muscle spasms can cause what you are feeling. Go to a PT and get some dry needling. If it doesn’t resolve the PT will send you to ortho.

What Jose said is spot on. Paraspinal strain with the tightening of your right QL. I've found that when QLs tighten they pull that hip slightly forward. When that happens you will automatically and without knowing rotate your femur to keep your foot from not being pigeon toad. This is going to tigthen up that Piriformis muscle as well. That's most likely the pain you are feeling in your butt.

A good PT should be able to sort you out. In the meantime go to YouTube and search stretches for QL and Piriformis.

Hope this helps.

Thanks for all the info guys, gonna drop in to a local PT and go from there.

Strength exercises for the lower back? I never really gave it focus before. Between my normal routine my lower back got plenty work. I took about 8 months off with the knee injury and surgery, came back tweaked my back squatting. Took time off tweaked it again on hack squat. Took more time off than this most recent injury. I’m hoping to have a plan in place soon to rehab then strengthen.

It will take an MRI to really know. After years of hoops and running I came down with severe lower back back. Had MRI and it was a herniated disc. That doesn’t go away.. Can only be managed by not doing what tweaks it.

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Strength exercises for the lower back?

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Walk around more when you're working. Even with a good chair, your hip flexors and abs get wrecked sitting in a chair for hours a day.

This will sound counterintuitive, but some of the best things you can do for your lower back involve your abs and stretching your hip flexors (on the front side of your pelvis.) Everything involves muscles in opposing places trying to compensate for their counterparts, etc.

Back and hack squats shouldn't put almost any pressure on your lower back, your hips may be in the wrong position, or you have a butt wink at the bottom, or other form issue.

My "chiropractor" is really full of a bunch of PT therapists, since I think she was a fitness model or something. A lot of PTs seem to be focused on geriatric and surgical recovery, but have clearly never deadlifted or anything in their lives. Make sure you're going to a PT with the right focus, which is to get you back into the gym.

Something else that piqued my interest: what are you thinking entering volleyball tournaments if you only work out 2-3 times a week?

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Butt wink for sure

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Everyone is obsessed with arse to grass, but you need to build stability it sounds like. I haven't done a squat that wasn't a box squat (you sit back, not really squat) that wasn't in a competition for a decade (not including overhead squats, which aren't really a leg exercise.) You hit the same depth, every time, and it should stop you before the butt wink.

For the ab work, make sure you do side bends, and *really* focus on how you hold air and keep your torso stable. You can spend most of an hour just doing overhead squats first with a broom, and then just the bar for abs too. If you do sets with only the bar for 30 minutes, you're going to know it (in a good way.) Hanging leg raises, glute ham raises, reverse hypers, all good.

Oh, and if you've got seat heaters in your vehicle, turn it on both on the way to your gym and on the way back. It helps me not tighten up, a lot.

Go to physical therapy first. Most private insurances won’t pay for a MRI without first failing 6 weeks of conservative treatment.

I was the tender young age of 37 and owned a condo overlooking the 6th green and 7th tee box of the DeSoto course in Hot Springs Village, AR. I had friends meeting there for a weekend of golf, so went a day early to get all the food ready and go play a practice 9 holes. The next morning, we teed off and on the 3rd hole I drove to the edge of the green on the short 305 yard Par 4. A chip and a short putt later I was leaned over to pick up my birdie ball, and feeling good at -2 under.

Then I tried to stand up straight and *just like that* my back went out. I could not play any more. My girlfriend drove me back home to Shreveport and by midnight I was in so much pain that I ended up in the hospital with a morphine drip.

Turns out that I have a slightly bulged disk (#3) and if I get any sort of muscle tear near it, the rush of blood to repair it creates swelling and inflammation that is almost unbearable. It created all sorts of problems for me. I've had spinal injections, cortisone injections and muscle relaxers in my life every since then. That was 30 years ago. I still have to be cautious, especially helping my 91 year old mom who needs help being lifted from time to time.

If I were you, I would get an MRI of your spine just to know what you're looking at. Mine can be repaired with the newer medical advancements, but insurance is like, "that's not enough of a protrusion to warrant surgery." Bastards. I typically know what not to do, and when to take anti-inflammatory meds (Aleve works great) or use a muscle relaxer (Soma).

Soma works great, but you need either a pain doctor or a family doctor who you have a good relationship with because most doctors are dissuaded to write a prescription for Soma, because it can be addictive to certain people. Doctors will write prescriptions for other muscle relaxers, but I find their side effects are terrible for me, whereas Soma will give me a high-like buzz starting about 10 minutes after taking it for about 20-30 minutes. After that, it works in the background and you don't feel any buzz any longer and can operate your yard tools and drive with a clear head, but I emphasize: Soma works well to alleviate the symptoms of back pain by reducing the inflammation and tension in your lower back. Ask for it from your doctor and if he won't prescribe it, ask for a referral to a pain specialist.

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Sounds like an aggravated low back strain, possibly the QL muscle.

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Yeah I had a girl I dated who was a massage therapist and she ran her fingers along that muscle while asking "is this what hurts?" my eyes snapped open, the fact that I finally felt it isolated changed everything.