I am currently working with two other authors to finish a clinical commentary on a rehabilitation program for athletes with lumbar disc herniation. During the time of writing, I had the unfortunate opportunity to have some discogenic flare-ups of my own, but took the experience as an opportunity to play with some exercises which will not be making it into the final print edition. One of these exercises is an old squat exercise called the belt squat which allowed loading of the lower extremity with less loaded involvement of the spine. In recent years, a number of manufacturers have built machines for belt squatting, but from a clinical perspective, you can get a pretty good start with a dip belt, some plates, and two sturdy/stable surfaces to stand on. I have to kick myself for not using this earlier on myself or clients in the past, in particular with posterior lumbar disc herniations and the class of conditions which fall under the MDT posterior derangement syndrome. Beyond simply unloading the spine from above and decreasing the musculature requirements necessary for maintaining spinal extension under load, the belt component may produce a treatment effect during the exercise. MDT practitioners are well aware of the benefits of over pressure in treatments of derangements, and the position of the belt (depending on it’s width) can be generally emphasize on various segmental levels to provide over pressure in the lower lumbar, or to simply facilitate an anterior pelvic tilt, depending on the goal. In addition, the over pressure is now maintained during a “functional” pattern of squatting (I guess this may be considered a Mulligan technique at that point). Clearly they need to be somewhat out of the most acute phase in order to even complete a body weight squat. Also, if they are already in a fairly anterior oriented pelvic tilt asymmetrically, the over pressure from the belt may irritate the involved SI joint.
From my own experience, this has been both psychologically beneficial, as it allowed me to continue to squat while recovering from the flare-up, but also that it assisting in calming down some of my radicular symptoms and low back pain. Your mileage may vary.
I have not had an chance to make my own video for this, so I defer to a great video from AllStrengthTraining.com as an example of the belt squat:
**Update – This guy has a similar setup to my own, everything is homemade. Not a bad option for a low budget clinic if you can make the structure a bit more stable: