Disc herniations are one of the most common lower back injuries.
In particular, a herniated L4 disc is the one of the most common types of bulge, second only to the L5
disc. This injury involves a weakness or tear in the outer covering of the intervertebral disc. You probably
already knew that, but what most people do not know is what caused the herniation or what makes the
The easiest way to get or aggravate a herniated L4 disc is to engage in repetitive flexion and extension
motion. Allow me to explain: flexion refers to the spine flexing (or rounding), while
extension refers to the spine returning from flexion to its normal lengthened state. Any motion
that repetitively takes the spine from a rounded back and then back to its normal position qualifies
as this type of activity.
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A lot of activities involve this type of movement. The most obvious example is sit-ups or
crunches. Crunches, especially on stability balls (which increase the range of motion of this
repetitive flexion-extension movement), emphasize this motion and can 1) make a herniated L4 disc worse and
2) increase the risk of another disc herniation. One herniated L4 disc is enough, there is no need
to work at getting more! It should be a crime for fitness gurus to market stability ball crunches as
a tool to help out back pain.
Core training is not something that can be blindly performed. A much more appropriate method for abdominal
training is an exercise such as a plank where the person holds the body in a pushup position for 30 seconds to a
minute, focusing on the feeling of the abdominals fatiguing.
In addition to performing too many crunches and sit-ups, a herniated L4 disc sometimes results from excessive
lower back motion during activities of daily living. The body is a master of compensation; when performing every
day tasks, such as tying your shoes, if your body is unable to get enough mobility from your hips and knees,
it will take extra movement from your lumbar spine in order to make up for this. When you consider how often
these movement tasks occur (picking up anything, reaching for an item in the back of a car, sitting down in
or getting up from a low seat), it is not surprising that bad movement increases the risk of a herniated disc.
Essentially, bad movement makes the discs work harder than they should have to. This increases wear and
tear and can ultimately lead to a herniated l4 disc.
The final risk factor for a herniated L4 disc is load applied to a flexed lumbar spine. In other words, if
the spine is rounded and you pick up an object (such as your briefcase or even a small
child), you are subjecting your spine to forces that could create a possible herniated L4 disc!
It is nearly actually impossible to herniate an intervertebral disc with the spine in its natural S shape.
However, when the spine is flexed, disc material is squeezed to one side of the spine by the surrounding
vertebrae. By adding load to this situation, the "perfect storm" is created which can lead an to a herniated
In essence, improving mobility and improving the quality of motion is a great way to prevent future disc
injuries and pain. I highly recommend the 7 Day Back Pain Cure (a free back pain book) as a resource for all types of back pain,
including the best way to handle a herniated L4 disc.
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