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Video Transcript
Central disc protrusion is the result in your MRI report. And this video, I’m going to give you three exercises for central disc protrusion to provide relief and comfort for symptoms and pain associated with either an L4 – L5 central disc protrusion or an L5 – S1 central disc protrusion. Hey there, it’s Dr. Walter Salubro. I’m a chiropractor in Vaughan, Ontario, Canada. Welcome to my channel. What this channel is about is giving you tips and strategies on how to strengthen and stabilize your back. So you can bend, move and lift normally and without limitation, like this you can live life normal again. So if you want these tips and strategies, go ahead and subscribe on that red subscribe button above, tap on the notification bell, like this you do not miss out on my weekly new videos.
A normal disc from the top view, the circumference of the disc is well maintained, the nucleus pulposus on the inside is well maintained and there are no annular fiber tears. Very, very important. Disc is healthy. When there’s damage to the disc when the annular fibers are torn, the inner nucleus pulposus pushes out. And a central disc protrusion is when that bulge pushes out centrally towards the spinal canal. And it begins to narrow down the spinal canal so it is often associated with central canal stenosis. The disc injury itself produces inflammation and is pain sensitive, causes pain and disability. If it’s a more diffused posterior disc protrusion or disc bulge, it may go more lateral, the circumferential bulge, and can actually irritate the nerves that come out from either side as well.
So that’s why these disc bulges are very painful. Now in the lumbar spine there’s no spinal cord in the lower lumbar spine segments, it’s usually the cauda equina nerves which emerged from the L2 area of the lumber area. So you’re not going to see a spinal cord like this, but when that disc protrusion becomes more moderate and more severe, it could compress on those cauda equina nerves, and cause more serious problems like neurologic deficit to the bladder or bilateral leg pain or numbness in the saddlery of the botox or inner thighs, shooting pain down both legs, that’s bilateral leg pain. So these exercises may help relieve some of that pain, discomfort by opening up that canal and relieving that pressure from that central disc protrusion. So there’s three exercises that I’m going to show you and let’s get right into the exercises. I’m going to demonstrate them and follow along as I describe how to do the exercises.
Disc Protrusion Exercise #1: Lumbar Extension
Exercise number one this is an extension McKenzie protocol exercise, helps relieve pressure in the lumbar discs. You lie flat and you lift your body, your chest off the ground. Keep your elbows flat though, do not lift your elbows up. This is the easier version. It helps relieve pressure by gapping up the spaces between the vertebra where the disc are. This is the more challenging version, more advanced version. It’s an extension exercise, helps relieve pressure in the lower lumbar region. You extend your arms out to get a better, bigger extension.
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Disc Protrusion Exercise #2: Standing Lumbar Extension
Exercise number two, this is a standing version of the low back extension exercise that you just saw. You place your hands in front of your thighs as you’re standing and you’re going to extend backwards as you’re seeing are in the video. And you can do this for 10 repetitions, hold the extension for about one second. Make sure you don’t go into any pain range, it should feel comfortable. And you are going to repeat that 10 times, like this, if 10 times is too difficult start with three or four and then work up to 10. And if 10 feels good, then you can do 20 or 30. All those within your tolerance. Very, very important. So you do repetitions of these extensions in a standing edition. This gives you a variation in case you can’t get on the ground, floor, or at work or location, or if you’re driving and you pull up in a parking lot to rest and the extension exercises can be done at a variety of different places or if you can’t get on the floor. It’s a great alternative. Next thing you can do is place your thumbs right behind the lower part of your back and push forward, get a bit of compression and distraction there as you extend backwards and hold it for 10 seconds or longer if necessary.
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Disc Protrusion Exercise #3: Lateral Bending
Exercise number three, it’s a lateral motion, a lateral bending exercise. This can be done for a central disc protrusion, both sides right and left if there is no leg pain. So if there is leg pain, so let’s say there’s left sided leg pain there could be also a lateral irritation of that disc on the nerve, on the left side. Then you want to bend to the right side. You hold the bending for one second and repeat it up to 10 repetitions. If there is no left sided or right-sided leg pain, then you can do bilateral, both sides. And we start with one side, opposite to any leg pain. So I’m here, you’re seeing the right side, hold it for one second, every repetition and repeat it 10 times. If it’s comfortable, you can go up to 20 and eventually to 30 times to your tolerance. It’s very good to open up that lateral aspect if necessary. Now here what I’m showing is they can also hold the position for an extended amount of time, 10 seconds or longer. This is the second variation. Now you’ll see the opposite. So now bending to the left side. if there’s right-sided leg pain, again, if there is no leg pain right or left, then you can do both sides together. But if you have one sided leg pain, then do the opposite. I hope that’s clear. So bending to the left side, slide the hand down the thigh and hold that for one second and do that repetitively and rhythmically. Good motion and good gapping of the disc and taking pressure off any nerves on the opposite side. As well, you can hold that for 10 seconds in the same direction like you saw before, sustained hold and 10 seconds to start work up longer if necessary
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So when can you do these exercises that can be done once in the morning or once in the evening or in the morning and in the evening, it’s your choice. Always do them within your tolerance, never do an exercise that causes more pain, or triggers more pain, and it may be advisable to get cleared by your doctor who assessed your spine.
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