I've always been a fan of intense training, I started lifting weights at 16 years old till I was 27, then decided to test my body abilities with something totally different, which was flexibility training/contortion. I never doubted my dedication and willpower to achieve anything I was putting my mind on. But what did my body think of that? I haven't had many exams done on my spine because honestly if you don't have pain, why would you do them? The first X Rays I have done on my back were taken at a Chiropractor's office in Miami (2010), I was occasionally suffering of upper back pain after sitting for long hours in school. They didn't find anything on my upper back, beside some scoliosis (which didn't worry me, it's very common) and something on my lower back (I don't have a report so I don't remember what was it, I remember though being asked if I've ever been in car accident (?!), but all I can remember was falling on ice few times in the winter years before, if that count as "trauma"). It didn't hurt at all so why worry. I also thought well for sure they want to find something wrong in me and get me to pay for sessions lol. These are the pictures I have from that time (not great quality, dated Sept 2010)
In 2012 I started training contortion, about a year later (June 2013) I did another X Ray on lower back (I was having constant soreness and discomfort in that area), nothing major came out, but the doctor noticed that the intervertebral space in L5-S1 joint (which is the lowest lumbar vertebrae attaching to the Sacrum bone) looked narrower and the "tail bone" (sacrum + coccyx) was tilted a little upward, not sure if caused by years of training or if I always had it. You can see here the X Ray:
Contrary to what you'd believe, having a more accentuated lower back curve (lordosis) DOES NOT help with back flexibility, because the back is constantly in a slight backward bend and never totally "resting" out of it. I believe people with straighter spines have a greater range of motion, less constriction and maybe less chances of developing back pain for this reason, but that's just my opinion since I haven't found a study to back it up. Anyway back to my tilted tailbone: this itself wouldn't be an issue (nobody has a "textbook" perfect spine), but it can cause stress into the facet joints, that are connecting points from one vertebrae to another, as you can see here
After acknowledging that, I started to avoid exercises that would force that particular joint to overwork or squish, like deep cobras, camels, and focused on engaging my abs more, lifting first the torso then bending back and opening the rest of my spine (middle, upper, neck). I would also perform several counter stretches (forward bending) at the end of my sessions. The pain went away after few months. Shortly after that, I went back into stretching my lower back and doing deep cobras like nothing happened (mistake!).
In December 2014, the pain came back more consistently and lasted till Spring 2015, sometimes I'd feel the pain down to my right buttock/leg, like sciatica pain. Feeling worried, I decided to do a lumbar MRI in April, it was time to check my lower back on a deeper level (MRI shows bones, ligaments, tendons, muscles, discs, it's a very in depth exam that detects all sort of anomalies, it's also very expensive to have it done). I know that there is no athlete in the world that has a perfect, injury-free body, so I wasn't expecting to find perfection at 30 yo having trained my butt off the last 14 years. Results came in: my muscles looked healthy with minor spasms here and there, vertebrae joints didn't show injuries/fractures or arthritis (only minor arthritis at certain facet joints) and overall discs looked nice and cushiony. The disc between L5 and S1 though lost some of its watery content and looked thinner (between your vertebrae there are discs, if they dry out or bulge the intervertebral space narrows, you can see discs only with MRI, CT scan etc). The doctor also noticed a slight lateral bulge to right (which is not herniation=rupture of disc and nerve touching into spinal canal and surroundings).
Types of disc bulging:
To understand: these are two lumbar vertebrae seen from top (axial view). The big round part is the disc, the dark "V" shape on the bottom represents facet joints. Between facet joints and disc is the spinal cord (in white, with little black holes which are nerve roots) branching onto each side. The image on left has a minus 90% disc protrusion, blocking nerve passing to left (which causes sciatica pain down buttock, leg etc and has a major risk of herniation). On right, the bulge is wider, in this case you can have a narrowed (not blocked) root canal, with or without symptoms (some people live all their life with disc degeneration or bulge not even knowing it). Mine was more like the right one.
One of most common causes of low back injuries to discs is lifting heavy objects rounding the spine:
In my case, having an upwardly tilted tailbone, a past of heavy lifting (deadlifts, squats etc.) and abusing of certain exercises made my low back weaker and sensitive, therefore I had to go through several adjustments in my training to find the best combination of exercises that would let me keep improving without aggravating L5-S1, and this time I was extremely motivated to do so.
After taking some time off, my main adjustments in my training were:
-Wearing a protective belt or back warmer when doing back bends
-Don't stress on a move if it feels painful and do focus on creating more space in other areas, like middle back and hips.
-Do traction exercises after each back bending session (lengthening of spine to promote separation in the discs, like hanging from a high bar with feet not touching the floor or someone pulling your legs)
-Strengthening abs and surrounding muscles
-Enough rest in between hard sessions
-Always be warm enough before trying deep stretches
-Side bending, to assure nutrients and fluids being pumped into discs
-Supplementing with at least 2 of the following: Omega 3 (anti-inflammatory and also containing strong antioxidant astaxanthin), chondroitin (stimulate nutrients and water absorption by connective tissue), glucosamine sulfate (to help and maintain healthy joints. Sulfate is needed by the body to produce cartilage).
Disc degeneration (thinning, loss of water in the discs) is believed to be natural with aging but irreversible, that's why it's better to take care of a disc the moment you know something is off. Discs are made of cartilage and, like tendons and ligaments, don't receive any blood supply to heal (blood contains red and white cells, plasma and PLATELETS-> their function is mainly blood clotting and healing of damaged tissue).
There are not many alternatives when it comes to cure something not "blood fed" like a tendon, bursa, ligament or a disc. Some doctors go from rest and avoid exercising, to cortisone shots (which take away pain but don't cure, sometimes damage nerves), to extremes like surgery. Only few doctors would suggest PRP Therapy, which is an advanced, newer technique to heal connective tissue and such.
Today I received good news, after about 6 months from my MRI I did another X Ray on lower back to check the situation, for me it's very important to know I train without hurting myself but optimizing my knowledge and time for a healthy productive training. The results were very positive, the L5-S1 regained more intervertebral space, reducing some tilting in the sacrum, which means more room for nerves and spinal cord :) Correcting my training helped tremendously. You can see here:
If you're doing contortion, especially at later age, please be careful especially of your neck and lower back (the two most flexible and most prone to injuries areas of your spine). This doesn't mean to be afraid of training intensely, just train smart, listen to your body and adjust your training as needed.