Asking your doctor, "what causes a bulging disc at L5 S1?" will most likely lead to the following answer, "you have weak muscles." But there's a massive problem with this answer, and it's a weak muscle is only half of the reason you're in pain. That's why in this article, I'm going to give you a more likely explanation for what causes a bulging disc in the lower back.
So why am I so confident in the answer I'm about to give you?
Because I am basing this information on how the body reacts to a bulging disc at L5 S1 (the most common spots), not how you got the herniated/bulging disc in the first place. You see, even though we could develop our bulging disc within the lumbar spine in a 1000 different ways, the body has very few ways in which it can react to that injury. And it's through this pattern that the body goes through that we can spot the most likely problem. So even if you developed a herniated or bulging disc from your dog jumping into your arms or from picking up a drill from the ground, your body would react 9/10 times in a very similar way.
If this weren't true, then there would be no way to perform studies on different kinds of pain, and doctors would have to perform in-depth assessments on every person with a bulging disc.
Of course, there are cases of a bulging disc in the lower back that has nothing to do with what I'm about to tell you. And the reason is that even though the body resembles the perfect machine, it can still go through a freak accident to create the pain.
I like to compare this to a car. A car will break down in only a handful of ways even though we all drive in different conditions and times. This is why we can have mechanics who know automatically what to do with any situation with the car. But if a car is blown up or smashed in a wreck, there's nothing a mechanic can do about it.
This is basically your body and when you get injured, it's most likely going to fall into a pattern.
Your Lumbar Spine is Nothing More than Multiple Joints
When simplified, the spine can be thought of as nothing more than a series of vertebra that stack neatly on top of each other to create individual joints. A bulging disc at L5 S1 can only happen if the vertebra above or below the disc begins to compress on it. (I'm also assuming you know what a bulging disc is at this point if you're looking for answers)
Some of the reasons you will find on the internet for the causes of a bulging/herniated disc are
- Aging and the process of wear and tear on the disc
- Dehydration (Cough, are you drinking enough water?)
- Excessive Weight
- Repetitive lifting, pushing, pulling, bending, twisting, etc., can also increase a bulging disc's chance. (Notice how these are all movements?)
So the question you need to ask is, what's causing my vertebrae to compress on the disc?
Muscles are the Key
If you want to move any bone around a joint, then a muscle is required to contract to move that bone.
It's not the Weak Muscle Creating Compression.
Now when you look for information on what causes a herniated disc or a bulging disc in the lower back and ask your doctors what you should do, 9/10 of them will suggest exercises because you have a weak core and lower back muscle. This is why you could have pain (not arguing there, just pointing out how similar all treatments are).
But as a Sports Massage Therapist and a Personal Trainer for over 8 years, I have seen both sides to the coin, and a weak muscles is only half right.
Here's what you need to know.
Every single muscle that moves a joint has an opposite muscle that performs the opposite action. Some examples are:
- Biceps flex the elbow, and triceps extend it
- Hamstrings flex the knee, and the quads extend it
- The glute medius abducts the hip, and the adductor magnus adducts it.
And with over 250 joints and 600 muscles within the human body, there can be multiple muscles moving a single joint and single muscles that move multiple joints. But when one of these muscles gets weak, just like what your doctor told you, then we get a muscle imbalance.
Because every muscle that moves a joint has an opposite muscle, there must be a balance between the 2 muscles, so the joint isn't compromised. Unfortunately, most of us have a muscle imbalance that is causing pain (or future pain) within the joint. A muscle imbalance is when one muscle is weak, one muscle is stronger/tighter, and because of this, the joint they help move is compromised and/or altered.
In my opinion, I believe this is actually one of the biggest reasons for early arthritis on one side of the joint, it's because there's most likely a muscle imbalance around the joint that is causing the excessive wear and tear.
An easy metaphor to understand this is a seesaw.
Imagine a seesaw with 2 anchors on the ends to prevent the plank from smashing into the ground. These 2 rope anchors are your muscles and the pivot point is the joint. (Image Above)
If the seesaw was balanced (meaning you had a muscle balance), there would be equal pressure on the seesaw's middle where it pivots. But if there is a muscle imbalance where you have a weak muscle that is elongated and stretched out and you have a contracted muscle that is shortened on the other side of the seesaw. Then the pivot point, which is your joint, will be compromised to one side. This extra pressure pulling to the front is most likely how you developed a bulging disc towards the back. (Image Below)
The stronger muscle within the muscle imbalance causes the vertebra to compress into the disc, causing a herniation towards the back. So why do doctors have you exercise the weaker muscles? It's because if these muscles were stronger, then it would help rebalance the vertebra, so there's no compression. "This muscle imbalance creates joint dysfunction ligamentous strain and INCREASED PRESSURE particularly at the L4-L5 and L5-S1 segments."
Bringing it back to the seesaw analogy, what most PT's are trying to do is exercise the weaker muscles to balance out the seesaw, which releases compression on the middle of the joint and relieves pain.
Why We're Prone to a Bulging Disc at L5 S1 and Why it Might Return
In today's society, we are set up for a disaster in terms of taking care of our bodies. I use to believe that we get pain as we get older, but now I believe it's years of living in a bad environment that created this pain, and it's only as we get older do we begin to feel this bad environment. This environment I'm talking about is sitting, and I truly believe it's how we set ourselves up for failure over time.
Why do I believe this?
Because younger generations are already showing similar issues as people 2x -3x their age. And the only real common factor is sitting, which is more and more becoming a requirement by modern society.
If you have ever wondered how you got a bulging disc without a major injury, it's most likely from sitting.
Bad Bio-Mechanics in the Spine
One of the first things that happen to us when we sit is the lumbar spine will shift forward from bad sitting posture. This repetitive sitting down not only creates compression to the front of your spine, but it also stretches and weakens the backside of the walls of the spinal disc called the annulus.
Now, something I learned from my years as a personal trainer is that the body's natural instinct is to always save energy. This means the muscles that help you sit down will begin to stay that way after long periods of time.
This Leads to Tight Muscles
There are 2 main groups of muscles that must contract for us to sit down and look forward. Those muscle groups are the hip flexors and the lumbar extensors. And even though we are supported with a chair and backrest, These muscles MUST still be contracting for us to be in this position. (To be clear, you're not going to make gains with these muscles contracting, but these muscles do become more hypertonic.)
And it's finally after years of using these muscles daily do they become so tight and tonic that the moment you stand up from bending over or sitting, these muscles refuse to stretch to their limit and pull down on the vertebra, creating compression on the front of the disc. And since the annulus is already weakened in the back, you end up getting things like a bulging disc or even a complete rupture towards the back.
Now what's interesting about these tonic muscles is when these muscles get tight, they begin to develop things like trigger points and fascia restrictions, which makes exercising the weaker muscle even harder. Plus, throughout the rest of the day, you will probably end up sitting back down, which will automatically relax and stretch out the muscles you just tried exercising.
So what's the answer to relieving a bulging disc once and for all? That's coming up in the next article.